Grand Canyon University: Healthcare Systems
The world has and populations have endured chronic illness, infectious disease, unsanitary conditions causing infections, and epidemics of disease. Epidemiology has allowed the population to live longer and allowed for advancements of medical care to provide public health options to treat such conditions or eradicate them with proper treatment. Epidemiology is defined as “the science and art of preventing disease, prolonging life, and promoting physical health and efficiency through organized community efforts for the sanitation of the environment, the control of community infections, the education of the individual in principles of personal hygiene, the organization of medical and nursing service for the early diagnosis and preventive treatment of disease, and the development of the social machinery which will ensure to every individual in the community a standard of living adequate for the maintenance of health.” by Charles-Edward A. Winslow (A brief history of public health.). Winslow was an American bacteriologist for public health.
Public health is about interventions that prevent disease from occurring (A brief history of public health.). Prevention of disease both prolongs life and improves the quality of life (A brief history of public health.). Public health is the proactive work before the disaster, illness, or epidemic occurs (A brief history of public health.). One example would be vaccinations to reduce or eradicate a disease.
Below is a timeline listing noteworthy events affecting the public health and epidemiology field, which then influences and changes the health care delivery system.
|1989||The Agency for Health Care Policy and Research (now the Agency for Healthcare Research and Quality) created (Digital Communications Division, 2017)The 100,000th AIDS case reported (Sencer, 2015).The 25th Surgeon General’s report on the health consequences of smoking is issued (Sencer, 2015).|
|1991||Reports a sharp increase in cases of tuberculosis in the United States, linked to HIV infection and AIDS (Sencer, 2015).Begins development of a national strategic plan for early detection and control of breast and cervical cancers among all American women (Sencer, 2015).In 1991, federal departments and agencies (16 total) adopted the Federal Policy for the Protection of Human Subjects resulting from the Tuskegee Trials (Reverby, 2009).|
|1992||Mammography Quality Standards Act requires all mammography facilities in the U.S. to be accredited and federally certified meeting quality standards (Milestones in U.S. food and drug law history1985)|
|1995||The Joint Commission issues a standard requiring all accredited hospitals to have a policy prohibiting smoking in the hospital (Wang & Tabshouri, 2018).|
|1996||The Joint Commission forms the Sentinel Event Policy to reduce serious adverse events and improve safety and learn from those sentinel events. Investigation and analysis of Patient Safety Events and corrective actions are essential to reduce risk and prevent patient harm(Wang & Tabshouri, 2018)|
|1997||On May 16th President Clinton apologizes on behalf of the Nation to the Tuskegee Study participants and families (Reverby, 2009).|
|1998||Mammography Quality Standards Reauthorization Act continues 1992 Act until 2002 (Milestones in U.S. food and drug law history1985). AIDS diagnosed in more African American and Hispanic men than in gay white men (Sencer, 2015). MMWR publishes the first Surgeon General’s report focusing on tobacco use among ethnic and racial minorities (Sencer, 2015)|
|2001||President’s Council on Bioethics was established due to the Tuskegee Study (Reverby, 2009)|
|2002||The Global Fund to Fight AIDS, Tuberculosis and Malaria is created to dramatically increase resources to fight three of the world’s most devastating diseases WHO in 60 years: A chronology of public health milestones).|
|2009||President Obama signs the Family Smoking Prevention and Tobacco Control Law. The Tobacco Control Act gives FDA authority to regulate the manufacture, distribution, and marketing of tobacco products to protect public health (Milestones in U.S. food and drug law history1985). This law FDA Center for tobacco products established (Milestones in U.S. food and drug law history1985). FDA announces a ban on cigarettes with flavors characterizing fruit, candy, or clove (Milestones in U.S. food and drug law history1985).|
|2012||CDC launches the groundbreaking “Tips from Former Smokers” national campaign to increase awareness about the suffering caused by smoking and to encourage smokers to quit (Sencer, 2015).|
|2019||CDC’s Lung Injury response efforts are committed to detect new and identifying risk factors of define the risk factors of e-cigarette, or vaping, product use-associated lung injury (EVALI) (Sencer, 2015).|
|Jan 2020||The Joint Commission has requirements, effective July 1 The Joint Commission has introduced new and revised requirements, effective July 1, 2020, for hospitals, critical access hospitals and ambulatory surgery centers that participate in the Advanced Total Hip and Total Knee Replacement (THKR) Certification program for hospitals, critical access hospitals and ambulatory surgery centers that participate in the Advanced Total Hip and Total Knee Replacement (THKR) Certification program (Wang & Tabshouri, 2018).|
AIDS continues to be a major world health struggle today. The arduous work of the CDC surveillance during the initial epidemic and investigation was critical in the prevention and discovery of HIV and AIDS etiology (Morbidity and mortality weekly report.2011). This allowed formulating prevention and safety recommendations targets to help halt the epidemic and provide treatment options Based in Geneva, Switzerland, the new program is cosponsored by six organizations of the UN family United Nations Children’s Fund (UNICEF), United Nations Development Program (UNDP), United Nations Population Fund (UNFPA), United Nations Educational, Scientific and Cultural Organization (UNESCO), World Health Organization (WHO), and the World Banks for infected patients (Morbidity and mortality weekly report.2011). This was a great public health service due to the advancement of education of transmission, natural history, and spectrum of illness, and prevention efforts and paved the way for development of the first effective treatments (Morbidity and mortality weekly report.2011). It is hard to imagine how devastating this epidemic would have been if the CDC would not have as they did. This impacted the healthcare system awareness about testing with the most recent campaign GYT is a campaign encouraging young people be tested and treated for STDs and HIV to protect their health and that of their partners (https://npin.cdc.gov/campaign/get-yourself-tested).
Based in Geneva, Switzerland, the program is made up of six organizations of the UN family United Nations Children’s Fund (UNICEF), United Nations Development Program (UNDP), United Nations Population Fund (UNFPA), United Nations Educational, Scientific and Cultural Organization (UNESCO), World Health Organization (WHO), and the World Bank (UNAIDS: An overview1996). Alongside WHO, other UN identify, develop and are a source of international best practice, that identify effective and ethical policies and strategies for prevention and care, promote and support research (UNAIDS: An overview1996).
Breast Imaging and MQSA
Mammography Quality Standards Act (MQSA) of 1992 requires that all mammography facilities meet certain high-quality standards. When a facility fails to meet the standards, the FDA requires it to notify affected patients and their referring health care providers that the study may be unreliable. The information regarding the site for noncompliance is listed on the FDA MQSA website for later reference (FDA, 2018).
The Joint Commission
The Joint Commission has a mission dedicated to providing a mission to improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value. This is done by accreditation with ambitious standards of commitment through evaluation by The Joint Commission, thus being recognized nationwide (Wang & Tabshouri, 2018).
The Sentinel Events are a patient safety policy set in place by The Joint Commission to decrease mistakes that result in the death, permanent harm, or severe temporary harm, or intervention required to sustain life(Wang & Tabshouri, 2018). The Joint Commission feels that reporting the event and learn from it, so it no longer happens contributes to improvement in public healthcare systems (Wang & Tabshouri, 2018).
The Tuskegee Study recorded the natural history of syphilis in hopes of justifying treatment programs. It was called the “Tuskegee Study of Untreated Syphilis in the Negro Male.” (Reverby, 2009). The study was conducted without the benefit of patients’ informed consent. It was an unethical research study and men were never given treatment (Reverby, 2009). When penicillin became available for syphilis in 1947, researchers did not offer it to the subjects (Reverby, 2009). The study last forty years and was unethical resulting in the President’s Council on Bioethics (Reverby, 2009),
For years public health programs and awareness have been trying to combat the tobacco industry and health risks associated with smoking and secondhand smoke. This goes back to the Surgeon’s general warning (Sencer, 2015), The Joint Commission not allowing smoking on sites for accreditation, The Tobacco Control Act gives FDA, and now the public health concern regarding risk factors of e-cigarette, or vaping, product use (Sencer, 2015).
It is easy to see that one area that our country is fighting for us, is the area of public health. In collaboration with many partners the advocacy that the average citizen can achieve is immense. Many resources are fighting for our health and wellbeing. With advancements of medicine, policies, and continued collaboration the nation will continue to flourish and gain awareness through education and provided resources. Patients have many outlets to reach out for help, and this may call for some life changes, but the benefits will be life changing.
A brief history of public health. Retrieved from http://sphweb.bumc.bu.edu/otlt/MPH-Modules/PH/PublicHealthHistory/PublicHealthHistory_print.html
Brown, T. M., Cueto, M., & Fee, E. (2006). Public health then and now. the world health organization and the transition from ‘international’ to ‘global’ public health. Washington, District of Columbia: American Public Health Association. doi:10.2105/AJPH.2004.050831
Digital Communications Division. (2017). HHS historical highlights. Retrieved from https://www.hhs.gov/about/historical-highlights/index.html
FDA. (2018). Mammography safety notifications.
Get yourself tested. Retrieved from https://npin.cdc.gov/campaign/get-yourself-tested
Milestones in U.S. food and drug law history (1985). . Rockville, MD: U.S. Dept. of Health, and Human Services, Food and Drug Administration, Office of Public Affairs. Retrieved from https://catalog.hathitrust.org/Record/007397700
Morbidity and mortality weekly report. (2011). Wilderness & Environmental Medicine, 22(1), 95. doi:10.1016/j.wem.2010.11.007
Reverby, S. (2009). Examining Tuskegee : The infamous syphilis study and its legacy University of North Carolina Press. Retrieved from https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=cat07789a&AN=gculc.b1193572&site=eds-live&scope=site https://lopes.idm.oclc.org/login?url=https://ebookcentral-proquest-com.lopes.idm.oclc.org/lib/gcu/detail.action?docID=475201
Sencer, D. (2015). CDC timeline . Retrieved from https://www.cdc.gov/museum/timeline/
UNAIDS: An overview (1996).
Victor J. Schoenbach, & with Wayne D. Rosamond.Understanding the fundamentals of epidemiology an evolving text
Wang, B., & Tabshouri, B. (2018). The joint commission vs joint commission international. Journal of Clinical Engineering, 43(2), 75-82. doi:10.1097/JCE.0000000000000265
WHO in 60 years: A chronology of public health milestones