Swimming Upstream? Patient Protection and Affordable Care Act and the Cultural Ascendancy of Public Health

DeVille, Kenneth; Novick, Lloyd F.

doi:10.1097/phh.0b013e318206b266

Cited by 11 publications

(4 citation statements)

References 18 publications

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“…Therefore, it is imperative to assess the gaps in service provision to build essential evidence for policy and practice. The objectives of this study are: (1) to examine the distribution of community health centers and local health department jurisdictions within the Great Lakes region, (2) to examine the distribution of maternal and child health services provided by community health centers and local health departments and identify spatial gaps in these services, and (3) to analyze the effect of the availability of services on population health outcomes. Although the authors' approach to mapping the gaps can be used for many other primary care services, prenatal care was selected because of its direct effect on infant mortality.…”

Section: Local Health Departmentsmentioning

confidence: 99%

“…1 More importantly, PPACA's provisions promise to elevate the status of disease prevention, wellness promotion, and population-based interventions. 2 The inclusion of these public health principles provides the incentive to address the problems associated with the public safety net and the considerable challenges facing safety net providers. Millions of Americans are expected to gain health insurance coverage under the law.…”

Section: Introductionmentioning

confidence: 99%

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Assessing Gaps in the Maternal and Child Health Safety Net

Mathis

Barnes²,

Shah³

2013

Population Health Management

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The Patient Protection and Affordable Care Act of 2010 proposed sweeping changes to health insurance and health care delivery systems. As a result, local health departments, community health centers, and other safety net providers are expected to play a role in providing access to care for millions of individuals. This study examines the availability of population-based services by local health departments and community health centers in the Midwest/Great Lakes region. For this study, the authors used secondary data on location of community health centers collected by the Health Resources and Services Administration and local health department services delivery from the 2008 National Profile of Local Health Departments. To simultaneously examine the geospatial patterns of service delivery and location of community health centers, the geographic information system shape files of local health department jurisdictions were used to examine prenatal care services. Additionally, the effect of service availability was examined by analyzing the rate of low birth weight births within the service areas of these facilities. Results show large variation in the distribution of community health centers. Additionally, the analysis of local health department services shows that prenatal care services are not available in every jurisdiction. Furthermore, the rates of low birth weight births in these areas are significantly higher than in areas where prenatal care is available. Future studies are needed to examine the relationship between safety net providers as well as their role in improving population health.

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Section: Local Health Departmentsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Assessing Gaps in the Maternal and Child Health Safety Net

Mathis

Barnes²,

Shah³

2013

Population Health Management

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“…The 2010 Patient Protection and Affordable Care Act provides for coverage of obesity, physical activity, and dietary counseling, not just in the context of disease management but also to prevent chronic disease (Bleyer, 2010; Koh & Sebelius, 2010). For older adults, Medicare will now reimburse providers for an annual wellness visit including discussion of patient prevention plans (DeVille & Novick, 2011; Tuma, 2012). Unfortunately, providers often view this counseling as futile and many feel they lack the time to incorporate this additional level of counseling when addressing complex patients’ existing chronic health concerns (Sherman & Hershman, 1993; Walsh, Swangard, Davis, & McPhee, 1999).…”

mentioning

confidence: 99%

Older Patients’ Recall of Lifestyle Discussions in Primary Care

2016

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Despite the known benefits of engaging in healthy diet and physical activity across the life span, suboptimal diet and physical inactivity are pervasive among older adults. While health care providers can promote patients' engagement in health behaviors, patient recall of recommendations tends to be imperfect. This study sought to better understand older adults' recall of dietary and physical activity discussions in primary care. One hundred and fifteen adults aged 65 and older were interviewed immediately following a routine primary care visit on whether and what they recalled discussing pertaining to diet and physical activity. Compared against transcripts, most patients accurately recalled their diet and physical activity discussions. The inclusion of a recommendation, and for diet discussions longer duration, increased the likelihood of patient recall for these health behavior discussions. These findings suggest that specific recommendations and an extra minute of discussion, at least for dietary discussions, increase the likelihood of accurate patient recall.

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“…While the Affordable Care Act is largely viewed by the public in terms of its impact on health insurance and access to health services, this act has many public health provisions including the Prevention and Public Health Fund, Community Transformation Grants, opportunities to increase integration with organizations providing clinical services, and mandated coverage for clinical preventive services. 3 Large urban areas have received the largest Community Transformation awards. In California, for example, the most populous jurisdictions receive greater resources to implement enhancements that facilitate population health: $497 076 to the 65 000 residents of Lake County to improve nutrition and physical activity; $3517 360 to the 488 000 residents of Sonoma County to address smoking in multiunit housing; and $7883 885 to 479 000 residents in Los Angeles to improve nutrition and physical activity and reduce tobacco use.…”

mentioning

confidence: 99%