Question

Access to Health Care: For Everyone, or Just for Some? Reflect on how public health measures have shaped their daily lives. Come up with one unmet public health need.

Answer 1

Health-related quality of life (HRQoL) is a multi-dimensional concept that includes domains related to physical, mental, emotional, and social functioning. It goes beyond direct measures of population health, life expectancy, and causes of death, and focuses on the impact health status has on quality of life. A related concept of HRQoL is well-being, which assesses the positive aspects of a person’s life, such as positive emotions and life satisfaction.

Clinicians and public health officials have used HRQoL and well-being to measure the effects of chronic illness, treatments, and short- and long-term disabilities. While there are several existing measures of HRQoL and well-being, methodological development in this area is still ongoing. Over the decade, Healthy People 2020 will evaluate the following measures for monitoring HRQoL and well-being in the United States:

• Patient Reported Outcomes Measurement Information System (PROMIS) Global Health Measure – assesses global physical, mental, and social HRQoL through questions on self-rated health, physical HRQoL, mental HRQoL, fatigue, pain, emotional distress, social activities, and roles.
• Well-Being Measures – assess the positive evaluations of people’s daily lives—when they feel very healthy and satisfied or content with life, the quality of their relationships, their positive emotions, their resilience, and the realization of their potential.
• Participation Measures – reflect individuals’ assessments of the impact of their health on their social participation within their current environment. Participation includes education, employment, civic, social, and leisure activities. The principle behind participation measures is that a person with a functional limitation—for example, vision loss, mobility difficulty, or intellectual disability—can live a long and productive life and enjoy a good quality of life.

Health care in the United States is provided by many distinct organizations Health care facilities are largely owned and operated by private sector businesses. 58% of US community hospitals are non-profit, 21% are government owned, and 21% are for-profit.^[2]According to the World Health Organization (WHO), the United States spent $9,403 on health care per capita, and 17.1% on health care as percentage of its GDP in 2014. Healthcare coverage is provided through a combination of private health insurance and public health coverage (e.g., Medicare, Medicaid). The United States does not have a universal healthcare program, unlike other advanced industrialized countries

In 2013, 64% of health spending was paid for by the government and funded via programs such as Medicare, Medicaid, the Children's Health Insurance Program, and the Veterans Health Administration. People aged under 65 acquire insurance via their or a family member's employer, by purchasing health insurance on their own, or are uninsured. Health insurance for public sector Employees is primarily provided by the government in its role as employer

The United States life expectancy is 78.6 years at birth, up from 75.2 years in 1990; this ranks 42nd among 224 nations, and 22nd out of the 35 industrialized OECD countries, down from 20th in 1990. In 2016 and 2017 life expectancy in the U.S. dropped for the first time since 1993. Of 17 high-income countries studied by the National Institutes of Health, the United States in 2013 had the highest or near-highest prevalence of obesity, car accidents, infant mortality, heart and lung disease, sexually transmitted infections, adolescent pregnancies, injuries, and homicides. A 2014 survey of the healthcare systems of 11 developed countries found that the US healthcare system to be the most expensive and worst-performing in terms of health access, efficiency, and equity

By the middle of the past century, health professionals predicted that we would conquer infectious disease. Now the current epidemics of human immunodeficiency virus (HIV), tuberculosis, malaria, and antibiotic-resistant infections, among many other threats, show how naïve that view was. Even though we understand what causes most of the world's plagues and have already devised medical tools and sanitation strategies to fight them, infectious diseases still claim millions of lives each year. These diseases remain major killers, largely because the tools and strategies do not reach the people who need them most: the poor of the poorest developing countries.