Public health issue by Arthur Marshall
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Transcript of Public health issue by Arthur Marshall
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Public Health Issue
Arthur MarshallLas Colinas Blvd, Texas, US
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APHA and Disability Awareness
From Chicago to San Francisco…
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Public Health and Disability
• Public health has historically been most important prevention oriented (e.g., immunizations, automobile safety belts).
• Those who produce disease or accidental injuries (e.g., polio, SCI) frequently “fall through the cracks.”
• Today we have 54 million Americans with disabilities -- 54 million--oopses!
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Significance of the Problem• Professional medical technology and
advancements have increased rates of survivors with severe trauma or serious circumstances.
• Survivors experience long treatment, yet health care program capitation forces compressed therapy and recovery time.
• Public health can provide a beneficial contribution in the health of people with problems as they move from medical settings into group living.
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Significance of the Problem• As of 9/30/03 there
were over 267,000 older people with disabilities living in nursing homes all over the US who want to live more separately in the community.
Source: www.cms.hhs.gov/states/mdsreports/res2.asp
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Significance of the Problem• Over 70% of adults
with handicaps are jobless, in comparison to the typical unemployment amount for non-disabled persons of 6%.
• Source: N.O.D./Harris Survey of Americans with Disabilities, 2000; US Dept of Labor Bureau of Labor Statistics October, 2003.
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HP 2010 Leading health indicators:• Overweight and Obesity • Substance Abuse • Mental Health • Immunization • Access to Health Care • Tobacco Use • Injury and Violence • Physical Activity • Environmental Quality • Responsible Sexual Behavior
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HP 2010 Leading health indicators:• Physical Activity • Overweight and Obesity • Substance Abuse • Mental Health • Environmental Quality • Immunization • Responsible Sexual Behavior • Injury and Violence • Tobacco Use• Access to Health Care
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Reported by: VA Campbell, PhD, JE Crews, DPA, L Sinclair, MPH, Div of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, MMWR, September 13, 2002.
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Getting Back to Work• Ticket to Work and
Work Rewards Enhancement Act of 1999 (TWWIIA).
• Gives people with handicaps resources to come back to work, or improve their current work situation (i.e., part time to full time).
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Getting Back to Work• TWWIIA ticket tracker
• As of 11/03/2003 over 5,626,633 “Tickets to Work” have been issues to people with disabilities across 34 states.
• Only 3,168 have used them with employment networks.
Source: http://www.ssa.gov/work/Ticket/ticket_info.html
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Attacking the Problems
• Public Health Research
• Public Health Practice
• Public Health Education
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Public Health Research• People with disabilities have at higher
health risks for health problems than those without having disabilities.
• People have disabilities often have higher health disparities compared to non-disabled people.
• CDC and other federal companies are putting more interest on research to help increase positive health results for the 54 million Americans with disabilities.
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Public Health Research• More exploration
needs to target both person and environment factors and their interactions to health outcomes.
• Essential progress is being made in the statistic of the natural environment and disability.
Person FactorsEnvironment Factors
Hea
lth O
utco
mes
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Public Health Research
• The IOM review, Allowing America noted that the majority of government funded disability research is focused on person factors (e.g., cure).
• Little public funding is being spent on environment risk and protective factors that affect health outcomes for individuals with present disabilities.
• CDC is one significant exception.
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Public Health ScienceImportant milestonesHealthy People 2010 – Chapter 6
• 13 health and fitness objectives working specifically with people with disabilities and their health differences.
• The cornerstone of this chapter is objective one whose result is that “disability status” be included as a demographic variable in all health-related reviews.
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Public Health ScienceImportant milestonesInternational Classification of Functioning (ICF)
• The ICF is the public health complement to ICD. ICD categorizes etiology to frame case definitions for primary protection.
• ICF classifies human functioning for improved public health science and policy.
• ICF also enables classification and coding of environmental factors impacting human function.
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Public Health Practice• There needs to be better
interpretation and “technology transfer” from the researcher to the PH practitioner—to improve particular public health results.
• “Living Well With a Disability”
• Research needs to be both rigorous and relevant.
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Public Health Practice• All public health courses need to recognize
the at-risk position of people with disabilities.
• This can be obtained by including people with disabilities in the planning and execution of the 10 necessary public health services.
• Like other minorities, people with disabilities carry a unique skills to creating and applying public health activities.
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Disaster Planning and Disability• Among those people with disabilities employed full or part
time, 50% say no plans have been made to safely evacuate their workplace.
• 58% of people with disabilities do not know whom to contact about emergency plans in their community.
• A public health collaboration to address disaster planning and emergency response for people with disabilities is currently under way in 30 national FEMA declared disaster counties.
NOD/Harris Poll, November 2001
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“To leave footprints in the sands of time… you must wear work shoes.”
Arthur Marshall, Original Posted by Old African Proverb