Jillana S. AhLoe
PhD
Student
College
of Nursing
University
of Utah
A paradigm shift is
taking place within the industries of health and medicine. Gone are the days
when the disease was more important than the patient. The practice of merely
treating disease no longer reigns supreme (Heikkinen, 2000). Now, industry
practice has shifted to hone in on disease prevention and health promotion.
Simply put, the modern healthcare system is shifting from prioritizing disease
to prioritizing health and prevention.
Providers
have changed their focus from what is more efficient and cost effective for
themselves to what is best for the patient. Doctors are changing their approach
of a one-size-fits-all diagnosis to a more personalized strategy which includes
innovations in the delivery of healthcare services due to advances in
technology (Rab, n.d.). More interestingly, for those who fancy a top-down
approach, a quick look at public policies such as the Healthy People initiative,
the Affordable Care Act, and the National Prevention Strategy illustrates how
this paradigm shift has been gaining traction. Don’t take my word for it. The
proof is in the policy.
Healthy People Initiative
Notice
how much the number of topic areas and objectives have increased. Observe how
the overarching goals become more detailed and specific with each iteration,
focusing more and more on health disparities. What differences exist with the
newly approved overarching goals framework for Healthy People 2030 (2018) outlined
below?
- Attain healthy, thriving lives and well-being, free of preventable disease, disability, injury and premature death.
- Eliminate health disparities, achieve health equity, and attain health literacy to improve the health and well-being of all.
- Create social, physical, and economic environments that promote attaining full potential for health and well-being for all.
- Promote healthy development, healthy behaviors and well-being across all life stages.
- Engage leadership,
key constituents, and the public across multiple sectors to take action and
design policies that improve the health and well-being of all.
The
Patient Protection and Affordable Care Act (ACA) was passed in federal
legislation during the Obama administration in 2010. This policy provides an
avenue to devote efforts to one of the underlying aims of the Healthy People
initiative – addressing racial and ethnic disparities in healthcare. Three
primary goals of the ACA are to expand access to health insurance, protect
patients against arbitrary actions by insurance companies, and reducing costs
to consumers.
A
few ways the ACA tackles health disparities is by forcing everyone to be
insured or pay a penalty, tracking patient racial and ethnicity data in a
standardized way, and increasing funding for research programs such as PCORI
(Griffith, Evans, & Bor, 2017). The Patient Centered Research Outcomes
Institute funds and supports research studies that examine differences in
patient outcomes among racial and ethnic minority groups.
National Prevention Strategy
Released
in 2011 by the National Prevention Council, this strategy is more evidence of
the shift from a disease-oriented paradigm to a prevention and health
orientation. As depicted in the diagram, this strategy prioritizes prevention
across multiple settings to improve health.
Also
noteworthy is how the seven priorities listed in the outermost circle coincide
with combating The Top 10 Leading
Causes of Death
in the United States.
Final Thoughts
The
public policies and initiatives briefly reviewed above are just a few examples
of how collaboration across a wide spectrum of agencies can positively affect
change. By setting guidelines at a national level for all to reference, a
united front is held at all levels, making a concerted multidisciplinary effort
towards the same goal.
As presented in
the National Prevention Strategy, many factors of health and well-being fall
outside of the health care setting. This is why a holistic approach is crucial
to making meaningful strides in shoring up a nation of healthy citizens. In
order to reliably say that the proof is in the policy, we must continue to
assess, evaluate, and improve policy outcomes.
Get
a jump start on conducting your own assessment by reviewing the Healthy People
2010 Findings.
What outcomes stand out the most to you?
References
Griffith, K., Evans, L., Bor, J. (2017).
The affordable care act reduced socioeconomic disparities in health care
access. Health Affairs. In Press. https://doi.org/10.1377/hlthaff.2017.0083
Healthy People 2010 Final Review:
Overview and Selected Findings (2013). National Center for Health Statistics.
Retrieved from https://www.cdc.gov/nchs/healthy_people/hp2010/hp2010_final_review.htm
Healthy People 2030 Framework (2018).
Office of Disease Prevention and Health Promotion. Retrieved from https://www.healthypeople.gov/2020/About-Healthy-People/Development-Healthy-People-2030/Proposed-Framework
Heikkinen, E. (2000). A paradigm shift: from disease to health
orientation. The Aging Male, 3(4), 171-176. DOI:
10.1080/13685530008500345
National Prevention Strategy (2011).
U.S. Department of Health and Human Services. Retrieved from https://www.surgeongeneral.gov/priorities/prevention/strategy/index.html
National Prevention Strategy (2011).
U.S. Department of Health and Human Services. Retrieved from https://www.surgeongeneral.gov/priorities/prevention/strategy/index.html
National Prevention Strategy: America’s plan for better health and
wellness (2011). National Prevention Council. Retrieved from https://www.surgeongeneral.gov/priorities/prevention/strategy/report.pdf
Patient-Centered Outcomes Research Institute. (n.d.). Retrieved from https://www.pcori.org/about-us
Rab, S. (n.d.). The paradigm shift in medicine and how it affects
technology. CIO Review. Retrieved from https://healthcare.cioreview.com/cioviewpoint/the-paradigm-shift-in-medicine-and-how-it-affects-technology-nid-3823-cid-31.html
Secretary’s Advisory Committee on National Health Promotion and Disease
Prevention Objectives for 2030 (2017). Retrieved from https://www.healthypeople.gov/sites/default/files/SecretaryHP2030AdvisCommMtng2.pdf
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