Review the World Health Organization’s (WHO) definition of health in Chapter 7 of your textbook. Then, write a research paper fulfilling the following requirements.
Why is the definition of health important to health policy?
Define the term “target population” as it relates to health policy.
How do societal influences impact the identification and definition process of policy?
Research a healthcare organization and highlight how their policies align or misalign with the WHO’s definition of health.
The paper
Must be four to six double-spaced pages in length (not including title and reference pages) and formatted according to APA style as outlined in the Ashford Writing Center.
Must include a separate title page with the following:
Title of paper
Student’s name
Course name and number
Instructor’s name
Date submitted
Must use at least four scholarly sources in addition to the course text.
Must document all sources in APA style as outlined in the Ashford Writing Center.
Must include a separate reference page that is formatted according to APA style as outlined in the Ashford Writing Center.
Defining
Health
Table
7-1
presents the view of health and health care espoused in the constitution of the World Health Organization. Although the UnitedStates is a U.N. member state, one would be hard put to find consensus in the United States on a number of the points that it cites as basicprinciples.
Asking people in the United States if health is more than the absence of illness or infirmity could produce a host of different responses. Somerespondents might come down on the side of physical and mental well-being but have a problem with trying to address social well-beingunder the heading of health. Indeed, the fact that we have millions of uninsured and do not provide mental health care to a large proportion ofthe population would seem to indicate a lack of commitment to physical and mental well-being.
Those analyzing or deciding on a policy need to understand the differences in the operational definitions of health that are representedaround the table. In the best of all possible worlds, those seated at the table would agree on thatdefinition and move on, but sometimes theart of politics depends, in part, on knowing when to try to agree on principles, or on actions, or on both, and whether to use limited politicalcapital to try to bring them into alignment publicly.
Table
7-1
Excerpts from the Preamble of the Constitution of the World Health Organization
…
the
following
principles
are
basic
…
• Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.
• The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction ofrace, religion, political belief, or economic or social condition.
• The health of all peoples is fundamental to the attainment of peace and security and is dep.
WHO Definition of Health and Healthcare Policy Alignment
1. Review the World Health Organization’s (WHO) definition of
health in Chapter 7 of your textbook. Then, write a research
paper fulfilling the following requirements.
Why is the definition of health important to health policy?
Define the term “target population” as it relates to health
policy.
How do societal influences impact the identification and
definition process of policy?
Research a healthcare organization and highlight how their
policies align or misalign with the WHO’s definition of health.
The paper
Must be four to six double-spaced pages in length (not
including title and reference pages) and formatted according to
APA style as outlined in the Ashford Writing Center.
Must include a separate title page with the following:
Title of paper
Student’s name
Course name and number
2. Instructor’s name
Date submitted
Must use at least four scholarly sources in addition to the
course text.
Must document all sources in APA style as outlined in the
Ashford Writing Center.
Must include a separate reference page that is formatted
according to APA style as outlined in the Ashford Writing
Center.
Defining
Health
Table
7-1
presents the view of health and health care espoused in the
constitution of the World Health Organization. Although the
UnitedStates is a U.N. member state, one would be hard put to
find consensus in the United States on a number of the points
that it cites as basicprinciples.
Asking people in the United States if health is more than the
absence of illness or infirmity could produce a host of different
responses. Somerespondents might come down on the side of
physical and mental well-being but have a problem with trying
3. to address social well-beingunder the heading of health. Indeed,
the fact that we have millions of uninsured and do not provide
mental health care to a large proportion ofthe population would
seem to indicate a lack of commitment to physical and mental
well-being.
Those analyzing or deciding on a policy need to understand the
differences in the operational definitions of health that are
representedaround the table. In the best of all possible worlds,
those seated at the table would agree on thatdefinition and move
on, but sometimes theart of politics depends, in part, on
knowing when to try to agree on principles, or on actions, or on
both, and whether to use limited politicalcapital to try to bring
them into alignment publicly.
Table
7-1
Excerpts from the Preamble of the Constitution of the World
Health Organization
…
the
following
principles
are
basic
…
• Health is a state of complete physical, mental, and social
4. well-being and not merely the absence of disease or infirmity.
• The enjoyment of the highest attainable standard of health is
one of the fundamental rights of every human being without
distinction ofrace, religion, political belief, or economic or
social condition.
• The health of all peoples is fundamental to the attainment of
peace and security and is dependent on the fullest cooperation
of individualsand States.
• The achievement of any state in the promotion and protection
of health is of value to all.
• Unequal development in different countries in the promotion
of health and control of disease, especially communicable
disease, is acommon danger.
• Healthy development of the child is of basic importance, and
the ability to live harmoniously in a changing total environment
is essential tosuch development.
• The extension to all peoples of the benefits of medical,
psychological, and related knowledge is essential to the fullest
attainment of health.
• Informed opinion and active co-operation on the part of the
public are of the utmost importance in the improvement of the
health of thepeople.
• Governments have a responsibility for the health of their
peoples which can be fulfilled only by the provision of adequate
health and socialmeasures.
Source
: Reproduced from: Constitution of the WHO, Basic Documents,
5. 45th Ed. Supplied 2006, October at
www.who.int/governance/eb/who_constitution_en.pdf
Defining
the
Target
Population
Just what population are we talking about? The history of
community mental health centers illustrates how difficult—and
critical—it can beto answer this question. A system designed to
help the developmentally disabled and severely and persistently
mentally ill morphed into ageneral mental health treatment
system in which many practitioners avoided the original target
group and concentrated on the morerewarding (professionally
and financially) cases (Torrey, 1997). As more and more states
now focus more intently on the original targetpopulation, many
of those previously served must rely more on private payment or
insurance or go without.
An analyst in charge of developing a maternal health program
policy who wanted to determine the health status of the target
populationmight start by looking at the health of all females of
childbearing age. But what constitutes childbearing age when 8-
year-old girls and womenin their 50s can give birth? An analyst
would have to put both an upper and a lower limit on the age
range in order to get a count of the targetpopulation.
Identifying
the
Health
6. Status
of
the
Target
Population
The next step after defining the target population is to assess its
health status. Many data sources are available for this task, but
sometimesthey do not match up exactly with the target
population that has been identified. The CDC demonstrated the
complex connection betweendefining the target population and
assessing its health status using available data in 2000 when it
reported on changes in serum foliate levelsin
noninstitutionalized women ages 15–44 who participated in the
National Health and Nutrition Examination Surveys from 1991
to 1994and in 1999 (CDC, 2000). It did not conduct a special
study of pregnant women or women of childbearing age, the
recommended targetgroup. Instead, it segmented the data in the
existing surveys and analyzed that. There certainly are women
bearing children after age 44,before age 15, and in institutions;
however, the age range covered most of the potential recipients,
and the differences in outcomes were sogreat that the analysts
did not feel the need for further refinements.
Looking at the health status of the target population in the
aggregate can often obscure differences between subgroups.
One frequently hearsabout the millions of people in the United
States who lack health insurance. Does their health status suffer
because they lack insurance?Sometimes and sometimes not.
Historically, many of the uninsured have been young people
who have made a calculated trade-off betweenthe cost of health
7. insurance and the fact that they are young and healthy (a group
sometimes referred to as “the young immortals”). Yes, theyare
more likely to have severe auto accidents than an older
population, but until one happens they are not part of the 20%
of the populationthat accounts for 80% of health care costs.
They are transferring the risk of low-probability events to the
public at large because they wouldprobably receive care
anyway. Others may want insurance and need it, but are simply
unable to afford it. The point is that there is plenty ofroom to
talk at each other rather than solve problems. One can talk
about the issue by discussing the uninsured as a bloc or about
the needsof specific segments. The important thing is that
analysts define clearly whom they are talking about.
Identifying
the
Factors
Determining
the
Health
Status
of
Concern
Within
That
8. Population
Causation is the bane of the policy world. Politicians and
polemicists would have us think that the right policy is certainly
this or definitelythat. If it were that simple, however, there
would be little need for analysis. The conclusions of studies
seeking causation are seldom as clearas obvious results of
taking the handle off the local water pump and watching the
cholera epidemic stop. Most policy problems support
thecharacterization by the Danish mathematician and poet Piet
Hein, who wrote, “Problems worthy of attack prove their worth
by hitting back.”Inference is one thing, and causation is
another.
If we return to our historical population of uninsured
individuals as a target (it will take years to understand the full
impact of the ACA), wefind that they have poorer health than
the average population, and data show that they are more likely
to postpone care and not fill aprescription because of cost and
have an avoidable hospitalization. One might counter that some
lack coverage because they are in poorhealth and cannot find
employment. Also, when one deals with a policy issue of
uninsured populations, one probably needs to address issuesof
the underinsured as well. Problems ofdefinition and causation
are also thornier because so many studies and analyses rely on
informationentered into the claims data bank, which does not
include information on the underinsured because they do not
generate claims.
Identifying
Methods
Realistically
Available
9. to
Change
Health
Status
With all the alternative solutions being offered for health policy
changes, the analyst needs to identify the few that are most
realisticeconomically and politically. By politically realistic, we
mean acceptable to those who are likely to fund and use the
analysis and implement itsfindings. Many potential actors may
express a preference for specific alternatives
a
priori
. The analyst must respect these preferences and stillkeep the
process simple enough that decision makers are not likely to
ignore the work or be confused by it.
Defining
the
Methods
Operationally
and
Optimally
In an industry with a recognized high degree of waste like
health care, one has to add the step of defining the alternatives
10. operationally byanswering the following questions:
1.
Has the alternative been in use?
a. If so, determine how it could be improved prior to applying
it in this context.
b. If not, define it in more detail to establish operational
feasibility.
2.
For the more promising, feasible, and relevant alternatives,
determine optimal methods and procedures for delivery.
3.
Use these optimal processes to determine costs and
effectiveness where relevant.