Term 1 Flashcards

Question

Trust in Healthcare

Answer 1

Greater diversity in health care workforce will increase trust in the healthcare delivery system among minority populations, and increase propensity to use health care services, improving healthcare outcomes. Hypothesis holds to be TRUE

Answer 2

more diverse pop of care providers=more advocation for needs of those they serve

Answer 3

Now must be accredited in CC for medical programs will take time to diversify work force- edu, college, decision to stay in the field- as society becomes more diverse we need to be able to communicate b/c we cant diversify as fast as the society is

Answer 4

Provider’s patient centeredness influences patient trust how we interact with people we care for influences the trust process/ engagement of the patient. must keep cultural concordance in mind- more important w/ taking care of adults. Patient-centeredness=key for trust

Answer 5

Biological-Genetics, Immunity, Nutritional status Socioeconomic-Occupation, income, Family, social networks, Self-esteem Behavioral-Risk-taking behaviors,Religious beliefs, Perceived susceptibility

Answer 6

health disparity- has different meaning for different people

Answer 7

endowed genetically w/ certain defects-determine whether low/high risk social, physical environment play a role in already predetermined health wellbeing becomes apparent-becomes feedback loop exposed to vrus/disease-become well again and cycle reinstates BUT doesnt always happen that way acute injury (MVC fire etc) and chronic disease affect us much more sig from a cost standpoint

Answer 8

environments we are born into can determine our health cost standpoint costs are also associated with our behaviors

Answer 9

“Racial or ethnic differences in the quality of health care that are not due to access-related factors or clinical needs, preferences, and appropriateness of intervention. Institute of Medicine, 2002. A particular type of difference in health closely linked with social, economic, or environmental disadvantage.” Healthy People 2020, DHHS, 2010.

Answer 10

ANY DIFFERENCE FOUND- if also disadvantages person it is also considered a disparity. Cost 229 BILLION in 2006 Race, ethnicity, gender, sexual identity, age, disability, socioeconomic status, and geography all contribute to an individual’s ability to achieve good health.

Answer 11

Employment - Unemployment much higher among Blacks, Hispanics, and American Indian/Alaska Natives in 2010 with unemployed adults much less likely to report their health as very good or excellent

Answer 12

Education - Highest percentage of adults not completing high school were Hispanic, persons below the poverty level, those with disabilities, and foreign born

Answer 13

Nutrition - Persons living in rural census tracts were more often lacking a nearby food retailer (grocery store) within ½ mile location is important but if below the poverty level, does not matter how close or far-do not have funds to buy what they need

Answer 14

Air quality - Minorities, foreign-born persons and persons speaking a non-English language at home more likely to live near a major highway resulting in increased traffic-related pollution and elevated risks for adverse outcomes exposure to poor air quality/ pollution, work related risk- higher among those who are less edu/ in lower skilled jobs

Answer 15

Work-related risks - Hispanic persons, low wage earners, and foreign born are more likely to work in high risk occupation and an elevated I less opportunity for advance/ lower wages= higher work related stress

Answer 16

Mortality- Work-related death and homicide rates are highest for Hispanics, non-Hispanic Blacks and males. high work stress linked to coronary heart disease, higher suicide/ traumatic injury rates

Answer 17

Substance abuse - Binge drinking more common among persons 18-34 years of age, men, Whites and persons with higher household incomes need resources to alcohol and drugs-typically misused among higher income

Answer 18

Teen pregnancy - Birth rates among Black and Hispanic teenagers double that of other groups

Answer 19

Smoking - Cigarette smoking rates remain high in persons of low socioeconomic status less money people make- the Higher the chance that they smoke

Answer 20

Infants born to black women are 1.5 to 3 times more likely to die than those born to women of other races/ethnicities.

Answer 21

American Indian and Alaska Native infants die from SIDS at nearly 2.5 times the rate of white infants.

Answer 22

African American men are more than twice as likely to die from prostate cancer.

Answer 23

Hispanic women are more than 1.5 times as likely to be diagnosed with cervical cancer.

Answer 24

Hispanics, African Americans, American Indians and Alaska Natives are twice as likely to have diabetes. minorities tend to be at higher risk for genetic issues huge increases in obesity in youth, esp in minorities

Answer 25

Rates of premature death from stroke & CAD higher in Blacks Drug-induced deaths highest among Native Americans and Whites Homicide rates highest in Black males Motor vehicle-related deaths highest among Native Americans- alcohol link??

Answer 26

Periodontal disease -present in half of Black and Hispanic adults over 30 Tb rate remain high among racial/ethnic minority groups Obesity increased significantly in minority boys and men Non-Asian racial/ethnic minorities experienced higher HIV rates

Answer 27

N. Americans-higher alcohol consumption + higher MVC death % periodontal disease-lack of access/money? why more obesity in boys/men- we are more sedentary, no more PE in schools, increased consumption (sodas, food

Answer 28

Occurrence has much to do with social features of society low income=higher stress=more likely to smoke=poorer heath. cant afford= even worse health

Answer 29

Migrants trend toward the rates of country of adoption: Age, gender, family history, Smoking, obesity, High blood pressure, High blood cholesterol, Diabetes, Physical inactivity, High stress

Answer 30

Blacks had worse access to care than Whites for one-third of measures, and AI/ANs had worse access to care than Whites for about 40% of access measures . Poor people had worse access to care than high-income people for all measures; and low-income people had worse access to care for more than 80% of measures

Answer 31

Asians had worse access to care than Whites for about 20% of access measures. Hispanics had worse access to care than non-Hispanic Whites for about 70% of measures.

Answer 32

Blacks received worse care than Whites, and Hispanics received worse care than non-Hispanic Whites for about 40% of quality measures. American Indians and Alaska Natives (AI/ANs) received worse care than Whites for one-third of quality measures.

Answer 33

Asians received worse care than Whites for about one-quarter of quality measures but better care than Whites for a similar proportion of quality measures. Poor and low-income people received worse care than high-income people for about 60% of quality measures

Answer 34

About half of all process and outcome measures showed improvement. Of the quality measures related to treatment of acute illness or injury, more than 80% showed improvement.

Answer 35

In contrast, only about 40% of quality measures related to preventive care and chronic disease management showed improvement. Acute treatment includes a high proportion of hospital measures, settings which often have more infrastructure to improve quality.

Answer 36

Health care quality and access are suboptimal, especially for minority and low-income groups. Overall quality is improving, access is getting worse, and disparities are not changing.

Answer 37

Urgent attention warranted to ensure improvements in: Diabetes care, maternal and child health care, and adverse events. Disparities in cancer care. Quality of care among states in the South.

Answer 38

Est. Federal infrastructures to reduce health disparities Transferred Office of Minority Health within DHHS to the Office of the Secretary Established six individual Offices of Minority Health within the DHHS.

Answer 39

Designated National Institute on Minority Health and Health Disparities. Created an Office of Minority Health within CDCP to monitor trends and evaluate programs and initiatives. first step- collect people and system to collect data to track disparities may give better markers to how quality of health is improving/ decreasing

Answer 40

Medicaid covers nearly 40 percent of African American and Latino children. . Expansion will costs at 100 percent in 2014 then lowering to 90 percent by 2020.

Answer 41

All individuals eligible for Medicaid up to 133 percent of federal poverty level ($14,404 for an individual in 2009). Of the 46 million people currently uninsured, 47 are living in household with incomes at or below 133 percent federal poverty guidelines

Answer 42

ACA prevents companies from denying insurance coverage to people who have pre-existing conditions or charging higher premiums. survey showed that a good portion of people have been denied due to pre-exist condition found that people would like to leave job but wont because afraid of losing insurance

Answer 43

Prohibits higher premiums based on gender and determining insurance rates and coverage according to race and ethnicity. Since minorities disproportionately affected by chronic conditions including, diabetes, heart disease, and cancer, this will be a significant factor in obtaining health insurance coverage

Answer 44

Create a marketplace for health insurance to provide choices to consumers in picking their health coverage Fill the gaps for people who do not qualify for Medicaid or have employer sponsored insurance.

Answer 45

Provide premium assistance to individuals up to 400 percent of poverty level to ensure affordable options. Hispanics and African Americans tend to have lower rates of employer sponsored coverage, making those groups more likely to take advantage of the new market created by health exchange

Answer 46

personal genetic makeup, environment, social environment and personal lifestyle- can all influence chance of disease as a society we can moderate that but at current point, not making enough change we will make change at a individual level- to maintain/minimize side effects of their current conditions

Answer 47

Less information given by providers to lower SES group patients

Answer 48

Persons trained to ask questions and show assertive behavior received better care

Answer 49

Provider IP skills more important than receiving health-related information Perceptions of competence associated with interpersonal skills

Answer 50

you can train people to ask more effective questions patient centeredness makes the info we convey more effective

Answer 51

our competence judged by how well we can communicate-that we present ourselves well (correct pronunciation ect) perceptions of our competance our based off our interpersonal disclosers

Answer 52

Despite improvement in the overall health of the majority of Americans, the burden of health disparities continues to disproportionately affect minority populations.

Answer 53

culturally sensitive- is different from competent (i.e. ability); sensitivity-refining a skill to identify a problem assesment-make others aware of different practices spread knowledge about patient centeredness we must have skills to care for people but its HOW we deliver those skills that makes us effective

Answer 54

solutions -recruit and train more diverse workforce but what about those already present? need to enhance CC/ sensitivity of those already in the field to improve care

Answer 55

Enhancing cultural competence & Expanding diversity within the health professions Most cited strategies for decreasing health disparities for persons of color and ethnic/cultural minorities

Answer 56

“The habitual and judicious use of communication, knowledge, technical skills, clinical reasoning, emotions, values, and reflection in daily practice to benefit the individual and community being served” Epstein & Hundret, JAMA, 287(2): 2002, p226

Answer 57

Cultural competence should be part of our core professional competencies, rather than an isolated aspect of medical care communication is key word added to JAMA statement

Answer 58

C4.8: Physician assistants must demonstrate a … sensitivity to diverse patient populations…defined as…sensitivity and responsiveness to patients’ culture, age, gender, and disabilities (NCCPA) A.2.3 Demonstrate an awareness of the humanity and dignity of all patients and related individuals within a diverse and multicultural society (NCOPE).

Answer 59

The curriculum must include instruction on multicultural issues and their impact on patient care. (ARC-PA Standard B6.01, 2010) The curriculum must provide instruction that emphasizes respect for self and others, adherence to concepts of privilege and confidentiality, and a commitment to the patient’s welfare? (ARC-PA Standard B6.02, 2010)

Answer 60

competency statement not that prescriptive- expectation but doesnt tell you how to do it

Answer 61

“No person in the United States shall, on the grounds of race, color, or national origin be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination” under any federally supported program (Civil Rights Act of 1964)

Answer 62

US Office of Civil Rights extends this protection to language, viewing inadequate interpretation as a form of discrimination CA of 1964 drives the legislation of language and communication skills we may not deny someone b/c of lang barrier- obligation to provide interpreter if you use government dollars-w/o providing they can deny you

Answer 63

Syndrome of attitudes and behaviors See own in-group as virtuous and superior and out-group as contemptible and inferior Cooperative relations with in-group, absence of cooperative relations with the out-group

Answer 64

Underpinning for ethnic conflict, war, consumer choice and voting In-group favoritism or out-group hostility privilege- impact on being in 'in' vs 'out' group. In group has control of the resources, if out group doesnt like it- not too much is done (tribes in Africa and Iraq ex-creates prob in society) Favoritism does occur

Answer 65

language, traditions, practices differences always ask for preferences and accommodate if possible (TCH patient, child, with mother) wanted the physician to knock and announce gender before entering- they did not- distrust was established-patient centeredness was forgotten at that moment

Answer 66

initial visual impressions-form a lot of attitudes

Answer 67

in a nursing home and wheelchair: South-east Asian, although it doesn't match current last name.. is she immobile or just weak? if she entered US as older adult (70-80) don't usually learn the lang

Term 1 Flashcards

(91 cards)