LU Health Systems Initiatives & Accessing Healthcare Services Response Discussion Hey Prowork,You are kindly required to respond to my classmates. They are four in number. You will respond to them individually. An individual comment should include 450 words, with 2 peer reviews and one reference from the book by Singh and Shi (Essentials of U.S. Healthcare Delivery). This should be easy for you now because you just worked on it for me. Please see the files attatched that include the threads from the students that you need to respond to. 1 hour ago
The Future of Health Services Delivery
Healthy People Initiatives are a series of 10-year plans, undertaken by the United States
since 1979, outlining key national health objectives. Healthy people 2020, the current initiative
was launched in 2010 with objectives which include identifying nationwide health priorities;
increasing awareness, and understanding awareness of determinants of health, disability and
diseases and providing measurable objectives that apply at all level. (Shi & Singh, 2019, p. 38).
The 2020 plan emphasizes the need to consider factors such as poverty, education, and numerous
aspects of the social structure that not only influence the health of populations but also limit the
ability of many to achieve health equity (Koh et al., 2011). As stated in Shi and Singh (2019), it
has four interrelated overreaching goals:
Attain high-quality, longer lives free of preventable disease, disability, injury, and premature
Achieve health equity, eliminate disparities, and improve the health of all groups.
Create social and physical environments that promote good health for all.
Promote quality of life, healthy development, and healthy behaviors across all life stages.
Healthy People 2020 initiatives partners with both public and private agencies to identify barriers
and challenges, assess local level uptakes, promote the use of programs through webinars,
offering training and technical assistance (Shi &Singh, 2019). It also makes use of tools like
MAP-IT Guide and Evidence- Based Resource Tool to ensure that the state and the local health
plans align with the Healthy People goals and objectives. To achieve health equity, Healthy
People 2020 will assess health disparities in the U.S, population by tracking rates of death,
chronic and acute diseases, injuries and other health- related behaviors for subpopulations
defined by race, ethnicity, gender identity, disability status or special health care needs (Shi &
Singh, 2019). As per DHHS (20105), the following indicators showed noteworthy progress:
fewer adults smoking cigarettes; fewer children exposed to secondhand smoke; more adults
being active and fewer adolescents using alcohol and illicit drugs (Shi & Sing, 2019).
Healthy People 2010
In January, the United States Department of Health and Human Services released Healthy People
2010, the nation’s health goals for this decade. Healthy People 2010 has two overriding goals: to
enhance life expectancy and the quality of life; and to eliminate health disparities between
different segments of the population (Ghandour et al., 2013). One of the goals was to eliminate
health disparities among children with special health care needs. A study conducted by Ghandour
et al (2013) How Children with Special Health Care Needs Fared analyzed the leading health
indicators (LHI) to lay out its progress. Estimates of leading health indicators for national health
objectives for children with and without special health care needs (SHCN) at 2 time periods
2003 and 2007 were compared. The LHI considered were physical activity, obesity, household
tobacco use, current insurance, personal health care provider, past-month depressive symptoms,
and past-year emergency department visits. During the periods of 2003 and 2007 children with
SHCN fared worse than those without SHCN with respect to physical activity, obesity,
household tobacco exposure, depressive symptomology, and emergency department visits, but
fared better on current insurance and having a personal health care provider. Physical activity
and access to a personal health care provider increased for all children, whereas the absolute
disparity in personal provider access decreased 4.9% (Ghandour et al., 2013). Additionally, the
proportion of SHCN children with private coverage decreased from 64.7% to 50.7% between
2001 and 2009-2010, while public coverage increased from 21.7% to 34.7%; the proportion of
CSHCN without any insurance declined from 5.2% to 3.5% (Ghandour et al., 2015). Below is a
SWOT analysis of the HP 2010 initiative to remove disparities between children with and
Increased public awareness and engagement
Continued shift from private to public
coverage, which is more affordable, offers
benefits that are more likely to meet CSHCN
needs (Ghandour et al., 2015).
Absolute disparity in personal provider access
decreased 4.9% (Ghadour et al., 2013).
LHI for physical activities showed overall
Children with SHCN fared worse than those
without SHCN with respect to physical
activity, obesity, household tobacco exposure,
depressive symptomology, and emergency
department visits (LHIs) (Ghandour et al,
SHCN children had more severe health
conditions and more health services need, but
they less commonly received care within a
medical home and had more unmet need
Lack of population-based initiatives
Only 17.7% of children with special health
care needs received services in a high-quality
service system (Strickland et al., 2011).
Its an included objective in HP 2020 (Koh et
al., 2011), so there is scope for further
Title V of the Social Security Act explicitly
links the purpose of the national maternal and
child health program to national health
objectives, including HP (Ghandour et al.,
2013), giving greater importance.
Development of greater monitoring tools for
Endorsement a strong publicprivate
partnership and a concerted effort by federal
Because states and communities differ
significantly regarding the challenges, they
face in achieving these LHI, they differ
significantly in how they approach
improvement (Strickland et al., 2011).
Tremendous variation was discovered
regarding the rates of success in attaining the
quality indicators and systems goal for
subgroups of the children with special health
care needs population (Strickland et al.,
Obstacles in terms of high-quality
and state programs serving children with
special health care needs, their families, and
their health care professionals (Strickland et
interventions when scaling up (Sodnik, 2010)
Hebrews 10:24 (NIV) -And let us consider how we may spur one another on toward love and
good deeds. Every Healthy People initiative should strive to grow in love and good deeds.
Ghandour, R. M., Grason, H. A., Schempf, A. H., Strickland, B. B., Kogan, M. D., Jones, J. R.,
& Nichols, D. (2013). Healthy people 2010 leading health indicators: How children with
special health care needs fared. American Journal of Public Health, 103(6), e99e106. https://doi.org/10.2105/ajph.2012.301001
Ghandour, R. M., Comeau, M., Tobias, C., Dworetzky, B., Hamershock, R., Honberg, L.,
Mann, M. Y., & Bachman, S. S. (2015). Assuring adequate health insurance for children
with special health care needs: Progress from 2001 to 20092010. Academic
Pediatrics, 15(4), 451-460. https://doi.org/10.1016/j.acap.2015.02.002
Houtrow, A. J., Okumura, M. J., Hilton, J. F., & Rehm, R. S. (2011). Profiling health and healthrelated services for children with special health care needs with and without
disabilities. Academic Pediatrics, 11(6), 508516. https://doi.org/10.1016/j.acap.2011.08.004
Koh, H. K., Piotrowski, J. J., Kumanyika, S., & Fielding, J. E. (2011). Healthy people. Health
Education & Behavior, 38(6), 551-557. https://doi.org/10.1177/1090198111428646
Shi, L., & Singh, D. A. (2019). Essentials of the U.S. health care system with access (5th ed.).
Burlington, MA: Jones & Bartlett Learning.
Sondik, E. J., Huang, D. T., Klein, R. J., & Satcher, D. (2010). Progress toward the healthy
people 2010 goals and objectives. Annual Review of Public Health, 31(1), 271281. https://doi.org/10.1146/annurev.publhealth.012809.103613
Strickland, B. B., Van Dyck, P. C., Kogan, M. D., Lauver, C., Blumberg, S. J., Bethell, C. D., &
Newacheck, P. W. (2011). Assessing and ensuring a comprehensive system of services
for children with special health care needs: A public health approach. American Journal
of Public Health, 101(2), 224-231. https://doi.org/10.2105/ajph.2009.177915
19 hours ago
Healthy People 2020
The Healthy People project begin in 1979 with the Surgeons Generals report on health
promotion and disease prevention (Bellamy et al., 2011). The Healthy People initiatives
established benchmarks for and monitored progress toward the following goals: to encourage
collaborations across communities and sectors, to empower individuals to make informed health
decisions, and to measure the impact of prevention activities (Shi & Singh, 2019). By trying to
meet these 3 goals will improve quality-based measures and will improve clinical outcomes by
improving care and increasing access to care. Healthy People 2020 (HP2020) will measure
general health status, quality of life and well-being, determinants of health, and disparities (Shi
& Singh, 2019, p. 38). In Healthy People 2020 rural health disparities are 1 of the 14 disparities
(Bolin et al., 2015). The HP2020 objectives provided insufficient data to evaluate rurality as a
Rural Healthy People project
Approximately 20% of the population lives in a rural setting (Bellamy et al., 2011).
Rural Healthy People (RHP2010) was developed in 2010 from Healthy People 2010 to assure
that rural Americas health needs are addressed. Even though 20% of the population is in rural
areas, only 9% of doctors and 16% of registered nurses practice in rural areas (Bolin et al.,
2015). Poverty is a major risk factor for poor health outcomes and poverty rates among rural
blacks is 32% and Hispanics is 27% which were significantly higher than those same populations
living in urban/metro areas (Bolin et al., 2015). Poverty, age, increase racial/ethnic diversity,
and infrastructure needs and lower educational attainment are several of the challenges in rural
settings. The biggest challenge in expanding Healthy People to rural communities is the lack of
locally available data and the reason is because of small numbers due to smaller populations. In
the HP2010 data it was found that out of the 314 objectives pertaining to states only 56% had
available data sources and of the 292 objectives pertaining to counties only 33% had data
available (Bellamy et al. 2011). Another barrier to care was access to care and it is the number
one thing needing improvement with HP2020. It was thought with the passing of the Affordable
Care Act and then the passage of the Health Information Technology for Economic and Clinical
Health Act Portion that it would improve the rural infrastructure and improve the electronic
medical records to help improve this data. One thing that we know now with HP 2020 is that the
issue of health disparities, racial/ethnic and geographic, cannot be solved solely by providing
affordable health insurance or by enabling the exchange of healthcare data (Bellamy et al.,
To improve health in U.S.
Implementation of quality goals to states
Achieve health equality
Promote quality of life
Improve quality of care
Lack of quality data
Not reaching goal
Lack of access to care
Ongoing disparities and subgroup of
In the study done by Bolin et al, 2015 a survey asked rural stakeholders to identify which of the
38-focus areas of HP 2020 was of greatest concern. The number one area was access to care.
This was also the number one area of concern in HP 2010. With passage of the Affordable Care
Act to improve infrastructure and access to electronic medical records it has improved data
collection and helped put together data from the small number counties and states to better
understand rural disparities. At this time, from HP 2010 to HP 2020, it has not met their selfdefined goals as stated early in this forum. The question in this country is if the political
environment will ever change. Without being able to provide basic health care needs to all of the
citizens in this country these initiatives will be hard to meet. Proverbs 21:5 The plans of the
diligent lead surely to abundance, but everyone who is hasty comes only to poverty.
Bellamy, G. R., Bolin, J. N., & Gamm, L. D. (2011). Rural healthy people 2010, 2020, and
beyond: The need goes on. Family & Community Health, 34(2), 182-188.
Bolin, J. N., Bellamy, G. R., Ferdinand, A. O., Vuong, A. M., Kash, B. A., Schulze, A., &
Helduser, J. W. (2015). Rural healthy people 2020: New decade, same challenges. The
Journal of Rural Health, 31(3), 326-333. doi:10.1111/jrh.12116
Shi, L., Singh, D., (2019) Essentials of the U.S. Health Care System (5thed.) Jones & Bartlett
49 minutes ago
DB FORUM 8 The Future of Health Services Delivery
CO LLAP SE
Many initiatives have been created and implemented to help people achieve quality-based
measurements and improve the overall outcomes of patients health. Although the United States
does not have a centrally controlled system of health care delivery, the nation does have a history
of federal, state, and local government involvement in health and social policy (Shi & Singh, 2019,
p. 307). Programs such as Healthy People 2020 initiative have set out to achieve numerous goals
associated with healthcare delivery. Shi & Singh (2019) suggest, These initiatives were founded on
the integration of medical care with preventative services, health promotion, and education;
integration of personal and community health care; and increased access to integrated care
services (p. 36).
The Healthy People Initiative has been around for quite some time now. The most recent
was the Healthy People Initiative 2010. This initiative was created with two main focuses in
mind. Its first was to be able to enhance life expectancies and improve the quality of life of
citizens in the U.S as well as to eliminate as many health disparities within the different U.S.
populations. These are issues related to gender, race, and ethnicity, education, income, disability,
and sexual orientation (Davis, 2000, p. 819). By doing so the 2010 initiative combined its efforts
with the 2000 Healthy People Initiative to achieve better outcomes which was headed by the
United States government department known as the U.S. Department of Health and Human
The Healthy People 2010 Initiative had a multitude of strengths. The most important
factor was its ability to provide a specific set of goals and strategies on helping improve then
then healthcare system at that time. With the implementation efforts to develop the priority areas
and their concomitant objectives are predicated to be enhanced from those of the year 2000
initiative. The focuses ware now on health promotion and disease prevention within the general
public and community groups (Institute of Medicine, 2010). As well as an emphasis on
monitoring the quality of care services, changes in epidemiologic knowledge and methods of
effective intervention (Institute of Medicine, 2010).
With any implementation of policy or initiative there will be negative components and
weaknesses within the goals and strategies. The Healthy People 2010 has its fair share of
described weaknesses. For one many of its objectives focused heavily on states and not the
governments role. Davis (2010) concludes that objectives targeted state and local
governments, healthcare providers and institutions, schools, employers, and others, but the
responsibility of the federal government was poorly defined (p. 819). Another weakness involved
the inconsistencies across the focus areas. Lastly, the scope of the Healthy People 2010 initiative
was away to take away valuable resources. The enormous scope of the Health People 2010
threatens to divert too many resources from health improvement activities to tracking (Davis,
As with anything in business there will always be room for growth and opportunities.
With the enactment and mandate by then President Barack Obama, the Affordable Care Act became a
great catalyst for addressing underserved populations. At this time there were many incentives and
goals for promotion of healthier outcomes and preventative measures for the entire U.S
population having access to affordable healthcare. One community in particular was found to have a
great need and this was rural areas. Within this initiative data collection and advocacy allows for
the rural populations to be represented in a more effective and inclusive manner (Institute of
The major threat that will continue to attack the Healthy People Initiatives is the
uncertainty of the Affordable Care Act. Until a solid remedy for the ACA is made into law there
will continue to be an up and down roller-coaster within the healthcare delivery system. Because of
the many components and frameworks of the Healthy People initiative there will always be
threats to its existence because of the changing ways in which the healthcare delivery system is
moving to meet he needs of its consumers. Health disparities such as community transmitted
diseases, unintentional drug overdoses, infant mortality and prematurity and other factors can
cause a threat to the Health People Initiatives (Davis, 2018).
Romans 14:19 states, So then let us pursue what makes for peace and mutual upbuilding
(English Standard Version). As a population of millions of people it is important to understand
the value in the improvement of our healthcare delivery system. Everyone deserves quality and
affordable healthcare and establishing initiatives such as those of the Healthy People Initiatives are
an effective manner to address the disparities that affect the worlds populations in a unified
Davis R. M. (2000). Healthy People 2010: objectives for the United States. Impressive, but
unwieldy. BMJ (Clinical research ed.), 320(7238), 818
Institute of Medicine (US) Committee on Leading Health Indicators for Healthy People 2010.
Leading Health Indicators for Healthy People 2010: First Interim Report. Washington
(DC): National Academies Press (US); 1998. 3, Development of Healthy People
2010. Available from: https://www.ncbi.nlm.nih.gov/books/NBK230480/
Shi, L., & Singh, D. A. (2019). Essentials of the U.S. health care system with
access (5th ed.). Burlington, MA: Jones & Bartlett Learning.
BUSI 511 Healthcare Administration
Dr. Pamela Kelly
July 2, 2020
Discussion Board Forum 8
Healthy People 2020 Initiatives and Improving Clinical Outcomes
In 1979, 10-year plans known as Healthy People began identifying important national
health objectives with the following goals: 1) to encourage collaborations across communities
and sectors, 2) to empower individuals to make informed health decisions, and 3) to measure the
impact of prevention activities (Shi & Singh, 2019, p. 36). Shi and Singh (2019) state that
benchmarks were created for these goals, and progress was monitored over the 10-year period.
Initiatives for each 10-year period were created with the incorporation of medical care and
preventative services, health promotion and education, the combination of personal and
community health, and improved access to integrated care services (Shi & Singh, 2019). In order
to reach the goals of each initiative, an action model was created. The action model assesses,
monitors, evaluates, and disseminates outcomes from interventions made through policies,
programs, and information on various determinants of health for individuals. For…
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