Healthy LifestylesHISTORY OF HEALTH CARE
Early civilization was concerned with health and
diseases. Illness was often attributed to natural
and
... [Show More] supernatural forces. Sometimes illness was
thought to be the result of some evil wrongdoing.
Diseases were often warded off by incantations,
magic, charms, or with the use of herb concoctions. At times, drastic measures were taken to rid
the body of demons, such as beating, torturing, or
starving the sick. Other cures relied on magic and
folk remedies. Even primitive surgery existed
before the advent of Greek medicine. In about the
6th century B.C., medical schools were established in Greece. Hippocrates was the first physician to believe that treatment should be based on
the belief that nature had a strong healing component. Diet, exercise, and hygiene became important to treatment.
Throughout the Middle Ages medicine and
religion were interwoven and several plagues and
epidemics killed millions of people. Understanding of disease processes did not occur until the
development of bacteriology, which took place in
the 19th century. Louis Pasteur, Robert Koch, and
Joseph Lister are some of the important scientists
who made significant contributions to the scientific understanding of health and disease during
this time. During the 20th century, a major cause
of death was infectious diseases, but environmental improvements in sanitation, water, and food
supply helped improve quality of life. Between the
years 1936 and 1954, the discovery and use of vaccines and antibiotics further reduced the number
of deaths resulting from infectious diseases.
Despite all of the improvements aimed at limiting the incidence and numbers of deaths from
infectious diseases, several diseases surfaced or
reappeared in the 20th century. Diseases such as
tuberculosis and measles have resurfaced, and
new infectious diseases such as human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), the Ebola virus, and
drug-resistant strains of organisms (Staphylococcus
aureus, Streptococcus pneumoniae, and Salmonella)
have become current health challenges facing the
population.
Many other achievements contribute to
longevity and health. Improvements and advances
in maternal and child care have led to decreases in
maternal and infant mortality rates. Better nutrition and hygiene, and improved technology also
have greatly reduced the risks to both mothers and
infants during the first year after birth. Still the
issue of having access to health care for all remains
a concern. Large numbers of childbearing women
do not seek out medical care during pregnancy,
increasing the risk to themselves and their infants.
Other areas of improvement include recognition of the risks associated with tobacco use,
genetic counseling, motor vehicle safety, and
advances in the diagnosis and treatment of heart
disease and strokes. Improvements in the workplace regarding safety and job-related hazards
have further reduced mortality rates. The mortality rate (death rate) today is lower than at any
other time in history.
The U.S. Department of Health and Human
Services first published Healthy People 2000. Building upon the objectives first identified, Healthy
People 2010 now continues in its belief in a systematic approach to improving health. This latest
publication includes a list of objectives and Leading Health Indicators that affect the health of
individuals and their communities. The belief is
Learning Objectives
At the end of this chapter, you should be able to:
• Describe the history of health.
• Describe the model for the nation’s health as proposed by Healthy People 2010.
• Describe the concept of health.
• List five healthy lifestyle practices.
• State the role of the practical nurse in health promotion.
• List two factors that interfere with people’s abilities to change their personal
habits.
2 Journey Across the Life Spancarrier. This sickness insurance as it was first
known was simple coverage for lost time during
sickness or injury. Years later, this coverage was
extended to include a worker’s dependents and
others. Before World War I there was some impetus toward compulsory health insurance following the initiative taken by several European
countries. “Industrial” policies were sold by Metropolitan Life and Prudential Life Insurance Companies. This early form of health insurance was
low in cost but basically provided for only a small
lump sum at the time of death to cover final medical expenses and the cost of a funeral and burial.
The Great Depression of 1929 changed the
financial security of hospitals and physicians. The
AMA continued to protest the concept of health
insurance recommending that “persons save for
the time of sickness.” In 1935 the Social Security
Act was passed by Congress. This act established
federal aid to states for public health and assistance. The Social Security Act became the foundation for the formation of Medicare and Medicaid
legislation in 1965. Many factors influence the
financing of the health-care system today, including providers, employers, purchasers, consumers,
and politicians. Controlling rising costs and making provisions for the estimated 40 million Americans who are underinsured or uninsured are the
two most pressing concerns today.
The U.S. health-care delivery system is one of
the most complicated and expensive systems in
the world. Despite its sophistication, this system is
unable to adequately address the need for universal coverage. There are currently several healthcare provider plans. Traditionally a person entered
the health-care setting and contracted directly
with a health-care provider. The provider was then
paid a fee-for-service. Managed health-care organizations have grown and become the dominant
form of health-care service used today. The growth
of managed care stems from the belief that costs
can be contained by managing the way health-care
services are delivered. Under this system, a primary
care provider (PCP) is assigned to provide basic
health-care services. Usually the primary healthcare provider is a physician, nurse, or physician’s
assistant. One aim of this system is to reduce the
numbers of hospital admissions, costly procedures, and referrals.
Health maintenance organizations (HMOs)
are the managed-care structure that is responsible
for the financing, organization, and delegation of
services for its members. The HMO provides a
that the health of the individual is closely linked
to the health of the community.
Two major goals take aim at increasing the
quality and length of a healthy life and eliminating health disparities. Life expectancy is the average number of years a person is expected to live.
Life expectancy has increased from 47.3 years at
the beginning of the 20th century to nearly 77
years today. Healthy People 2010 seeks not only to
extend life expectancy but also to improve the
quality of life. The second goal is to eliminate the
health disparities among persons that exist
according to gender, race, ethnicity, education,
income, disability, location, and sexual orientation. Regardless of differences, this initiative is
dedicated to making certain that all people in our
nation have equal access to fulfilling their healthcare needs. For more information visit http://
www.health.gov/healthypeople/.
Health indicators spotlight the major health
priorities for the nation. The Leading Health Indicators are listed in Table 1-1.
HEALTH CARE DELIVERY
The U.S. health-care system in the 19th and early
20th centuries was dominated by physicians and
hospitals. In these times, there was a close relationship between patient and doctor. Physicians
set fees, billed, or collected payments. Often
physicians adjusted fees based on a patient’s ability to pay. For many years the American Medical
Association (AMA) fought against having any
third party interfere or come between the patient
and physician regarding any medical matter.
In the early part of the 19th century some
Healthy LifestylesHISTORY OF HEALTH CARE
Early civilization was concerned with health and
diseases. Illness was often attributed to natural
and supernatural forces. Sometimes illness was
thought to be the result of some evil wrongdoing.
Diseases were often warded off by incantations,
magic, charms, or with the use of herb concoctions. At times, drastic measures were taken to rid
the body of demons, such as beating, torturing, or
starving the sick. Other cures relied on magic and
folk remedies. Even primitive surgery existed
before the advent of Greek medicine. In about the
6th century B.C., medical schools were established in Greece. Hippocrates was the first physician to believe that treatment should be based on
the belief that nature had a strong healing component. Diet, exercise, and hygiene became important to treatment.
Throughout the Middle Ages medicine and
religion were interwoven and several plagues and
epidemics killed millions of people. Understanding of disease processes did not occur until the
development of bacteriology, which took place in
the 19th century. Louis Pasteur, Robert Koch, and
Joseph Lister are some of the important scientists
who made significant contributions to the scientific understanding of health and disease during
this time. During the 20th century, a major cause
of death was infectious diseases, but environmental improvements in sanitation, water, and food
supply helped improve quality of life. Between the
years 1936 and 1954, the discovery and use of vaccines and antibiotics further reduced the number
of deaths resulting from infectious diseases.
Despite all of the improvements aimed at limiting the incidence and numbers of deaths from
infectious diseases, several diseases surfaced or
reappeared in the 20th century. Diseases such as
tuberculosis and measles have resurfaced, and
new infectious diseases such as human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), the Ebola virus, and
drug-resistant strains of organisms (Staphylococcus
aureus, Streptococcus pneumoniae, and Salmonella)
have become current health challenges facing the
population.
Many other achievements contribute to
longevity and health. Improvements and advances
in maternal and child care have led to decreases in
maternal and infant mortality rates. Better nutrition and hygiene, and improved technology also
have greatly reduced the risks to both mothers and
infants during the first year after birth. Still the
issue of having access to health care for all remains
a concern. Large numbers of childbearing women
do not seek out medical care during pregnancy,
increasing the risk to themselves and their infants.
Other areas of improvement include recognition of the risks associated with tobacco use,
genetic counseling, motor vehicle safety, and
advances in the diagnosis and treatment of heart
disease and strokes. Improvements in the workplace regarding safety and job-related hazards
have further reduced mortality rates. The mortality rate (death rate) today is lower than at any
other time in history.
The U.S. Department of Health and Human
Services first published Healthy People 2000. Building upon the objectives first identified, Healthy
People 2010 now continues in its belief in a systematic approach to improving health. This latest
publication includes a list of objectives and Leading Health Indicators that affect the health of
individuals and their communities. The belief is
Learning Objectives
At the end of this chapter, you should be able to:
• Describe the history of health.
• Describe the model for the nation’s health as proposed by Healthy People 2010.
• Describe the concept of health.
• List five healthy lifestyle practices.
• State the role of the practical nurse in health promotion.
• List two factors that interfere with people’s abilities to change their personal
habits.
2 Journey Across the Life Spancarrier. This sickness insurance as it was first
known was simple coverage for lost time during
sickness or injury. Years later, this coverage was
extended to include a worker’s dependents and
others. Before World War I there was some impetus toward compulsory health insurance following the initiative taken by several European
countries. “Industrial” policies were sold by Metropolitan Life and Prudential Life Insurance Companies. This early form of health insurance was
low in cost but basically provided for only a small
lump sum at the time of death to cover final medical expenses and the cost of a funeral and burial.
The Great Depression of 1929 changed the
financial security of hospitals and physicians. The
AMA continued to protest the concept of health
insurance recommending that “persons save for
the time of sickness.” In 1935 the Social Security
Act was passed by Congress. This act established
federal aid to states for public health and assistance. The Social Security Act became the foundation for the formation of Medicare and Medicaid
legislation in 1965. Many factors influence the
financing of the health-care system today, including providers, employers, purchasers, consumers,
and politicians. Controlling rising costs and making provisions for the estimated 40 million Americans who are underinsured or uninsured are the
two most pressing concerns today.
The U.S. health-care delivery system is one of
the most complicated and expensive systems in
the world. Despite its sophistication, this system is
unable to adequately address the need for universal coverage. There are currently several healthcare provider plans. Traditionally a person entered
the health-care setting and contracted directly
with a health-care provider. The provider was then
paid a fee-for-service. Managed health-care organizations have grown and become the dominant
form of health-care service used today. The growth
of managed care stems from the belief that costs
can be contained by managing the way health-care
services are delivered. Under this system, a primary
care provider (PCP) is assigned to provide basic
health-care services. Usually the primary healthcare provider is a physician, nurse, or physician’s
assistant. One aim of this system is to reduce the
numbers of hospital admissions, costly procedures, and referrals.
Health maintenance organizations (HMOs)
are the managed-care structure that is responsible
for the financing, organization, and delegation of
services for its members. The HMO provides a
that the health of the individual is closely linked
to the health of the community.
Two major goals take aim at increasing the
quality and length of a healthy life and eliminating health disparities. Life expectancy is the average number of years a person is expected to live.
Life expectancy has increased from 47.3 years at
the beginning of the 20th century to nearly 77
years today. Healthy People 2010 seeks not only to
extend life expectancy but also to improve the
quality of life. The second goal is to eliminate the
health disparities among persons that exist
according to gender, race, ethnicity, education,
income, disability, location, and sexual orientation. Regardless of differences, this initiative is
dedicated to making certain that all people in our
nation have equal access to fulfilling their healthcare needs. For more information visit http://
www.health.gov/healthypeople/.
Health indicators spotlight the major health
priorities for the nation. The Leading Health Indicators are listed in Table 1-1.
HEALTH CARE DELIVERY
The U.S. health-care system in the 19th and early
20th centuries was dominated by physicians and
hospitals. In these times, there was a close relationship between patient and doctor. Physicians
set fees, billed, or collected payments. Often
physicians adjusted fees based on a patient’s ability to pay. For many years the American Medical
Association (AMA) fought against having any
third party interfere or come between the patient
and physician regarding any medical matter.
In the early part of the 19th century some
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