Public Health Promoting in a Community - Report Example

The Strengths and Weaknesses of Morbidity and Mortality Data in Identifying Priorities for Promoting Public Health in a Community Introduction Promoting public health is important because the evidence shows that it helps the people to understand health issues and can prevent health problems (Earle in Earle, Lloyd, Sidell and Spurr, 2007). This would eventually improve the health standard of the communities who have been thrived on diseases. For the health specialists, promoting public health will increase public health standard because, says Earle (ibid), they can (1) monitor and assess public’s health and well-being through the mortality and morbidity data; (2) promote and protect the population from unwanted diseases and improve their well-being; (3) develop quality and risk management within certain culture or environment that is vulnerable to diseases; (4) work collaboratively with other health care workers or health care professionals; (5) develop health programs to reduce inequalities; (6) develop, formulate and implement health policy and strategy; (7) work with and help the communities; (8) develop strategic leadership in terms of health care; (9) conduct research and development in health associates; and (10) perform self management and be able to manage people and resources. In fact, health care has been one of the most controversial issues in any country and dear to many because it involves human life. Indeed healthcare database has been made available for technology assessment and health policy research (Roos, Roos, Fisher & Bubolz, 1990). In the insurance field, healthcare databases help the insurance company to identify patients, the type of service rendered by the physicians, the date when the service was rendered, and who was the physician who gave the service. For the physician, the databases help him to identify patient’s characteristics, give out proper diagnoses and treatment. According to Roos, Roos, Fisher & Bubloz (1990), database has the characteristics of system wide coverage of entire population, it has unique identifying number because it records the history of services the patient receives, and easy to enroll new patient and it has comprehensive information about the patient. The Strengths and Weaknesses of Morbidity and Mortality Data in Identifying Priorities for Promoting Public Health in a Community The Strengths The benefits of having morbidity and mortality data, as mentioned by Roos, Roos, fisher & Bubloz (1990) are: (1) it serves as a monitoring mechanism for effective treatments. For example, the mortality data in the hospital helps the hospital administrative management to compare the number of patient, patient’s length of stay, changes, treatment, and or service analysis, quality of services, patient’s cases or type of treatment needed, satisfactory factor, and readmission. In other instances, monitoring the spread of a disease can be done through screening (Earle, Lloyd, Sidell, and Spurr, 2007), which upon intervention, the morbidity or mortality rate can be reduced (ibid). (2) it serves as a tool to evaluate the efficacy and effectiveness. This may include the physician is uncertain about the type of treatment should he or she gives to the patient, the choice of treatment, the rarity of the case, and it eases the evaluation of the quality of service. (3) it provides a large number of data that can be used as a control measure to reduce the morbidity and mortality rate, and to identify morbidity or mortality patter. (4) accurate recording can identify the history of the patient and the treatment. (5) it permits unobtrusive research. (6) it allows multiple comparison between patients. (7) researcher can design cohort and case study control. (8) there is potential for specific or multiple studies and (9) it serves as data bank. Michel (2002), on the other hand, indicates that the benefit of having mortality and morbidity data is that it allows standardization method of data collection. This makes the method of estimating the nature of disease, patient diagnosis and treatment to be more effective. In addition, it reduces the likelihood of underestimating the adverse effects of treatment. In general, says Michel, the reporting system is less reliable because it cannot provide valid epidemiological data. For example, he states, the mortality and morbidity information is often underestimated or between 50% and 95% of the incidents are unreported. Similarly, the World Bank report indicates that the unreported cases are particularly associated with environmental health, injuries, natural disasters or road fatalities (http://www.worldbank.org/afr/environmentalhealth/chapter5.pdf). Earl, Lloyd, Siddel & Spurr (2007), on the other hand, argue that mortality and morbidity are influenced by gene or that there is a strong relationship between ethnic and health, particularly when it comes to chronic diseases such as heart disease, diabetes, etc. Although it may be true that ethnic or gene may affect a person’s health condition, like the World Bank report, environmental factors do play important role in the stability of a person’s health. Although the information on database is limited, it can inform the user of the data, particularly the physicians or other health care professional so that they can perform proper diagnosis and design the right treatment or intervention. The other strength of having mortality and morbidity data is that it can influence action and prevention. In terms of promoting health, the World Bank suggests that it is essential to prioritize “remedial measures to health problems because traditional health data do not reflect causes or solutions” (http://www.worldbank.org/afr/environmentalhealth/chapter5.pdf, p. 82). The available data, despite its limitation, can help the managers to monitor the impact of the disease on health, track its trend, identify the population which is affected by the disease severely (Dailey, Watkins, Riley, and Plant, 2007) and predict the disease trends and behavior. To promote community health, it requires professionalism (CDC, 1999). It requires health professional to strive beyond infectious disease, chronic disease, violence, emerging pathogens, terrorism, or bioterrorism (ibid). Public health professionals are required to work across program areas. They are required to collaborate with other health professionals to promote health and influence the community to improve their health. The established data helps the health professionals to design effective program evaluation, which is “a systematic way to improve and accounts for public health actions by involving procedures that are useful, feasible, ethical and accurate” (CDC, 1999). The data collected during the times the patient has come in contact with health care system, the data can be generated - from the first time the patient visits the health care system such as from childhood to adulthood (The Partnership for Childhood Development, 1999) – then captured and incorporated into a, for example, bio-surveillance system. Bio-surveillance system is a system of approach that based its information about the events when the disease occur prior to diagnosis, and can serve as an early indicator when the disease becomes an epidemic (ibid). This system can also serve as early warning to detect the spread of diseases among the community such as influenza or influenza like disease. Proctor, Blair & Davis (1998) describe that this system is remarkable particularly during surveillance peak such as during the 1993 cryptosporidiosis outbreak in Milwaukee. As a lesson learned, this system provides quick access and quick link to laboratory data. It helps the staffs to update existing information. This system can also be used as a tool to measure morbidity that triggers public outcry, helps with the diagnosis and treatment process, and reduce the high level of morbidity (ibid) and mortality rates. The data can also serve as surveillance data. As surveillance data, it can help managers or leaders to identify an effective control strategy and to evaluate the priority groups for treatment (Dailey, Watkins, Riley, and Plant, 2007) in terms of prevalent health issue. Surveillance is indeed an effective strategy or tool to assess contagious or virulent diseases such as influenza activity (ibid). Sometimes, people want to do self-help to their influenza; yet, early detection can reduce its potential spread. The data can also be collected and analyzed for proper intervention. The analysis may produce a trend of morbidity and mortality over time, including the causes of mortality (The Partnership for Child Development, 1999) which can be used to identify future intervention (ibid) or proper intervention. One of the trends it can produce, for example, is life expectancy. According to Blackman, Masi, Villarruel, and CDC in Fleckensten, 2006), life expectancy of average American is increasing but the mortality rate of the minority is increase either due to asthma or the environment (CDC in Fleckensten, 2006). In Western Europe, on the contrary, the mortality rate is increasing (Hem, Næss and Strand, 2007). People who live in poverty and social exclusion and in labor sector are more prone to have high mortality rate because of poor living condition (Earle and O’Donnell. In Earl, Lloyd, Siddel & Spurr, 2007). From the data, information about gender can also highlight the risk of mortality. For example, Earl, Lloyd, Siddell & Spurr (2007) indicate that the mortality rate among women in developing countries is higher than that of women in the advanced countries. Besides gender, life style and age also contribute to the benefit of predicting a person’s life expectancy and their pattern of behavior that affects their health (Earle and O’Donnell. In Earl, Lloyd, Siddel & Spurr, 2007). For example, in the United Kingdom, mortality rate among older generation is higher particularly during winter season (Earl, Lloyd, Siddel & Spurr, 2007). The data concerning gender also highlights the risk of mortality. For example, Earl, Lloyd, Siddel & Spurr (2007) indicate that the mortality rate among women in developing countries is higher among women in the advanced countries, while in the United Kingdom, the mortality rate among older generation is higher particularly in winter season. In other instances, isolating older generation in certain facilities is not only risk their physical, psychological, and emotional stability but may contribute to the high rate or mortality among older generation (Berg and Cassells, 1992). All this information can be obtained in a fingertip of a database, which will help the researcher or health professional in promoting health in the community by using proper methodology and proper intervention. The weaknesses Roos, Roos, Fisher & Bubloz (1990) indicate that the weakness of having database in this matter, or like any other matter, are (1) the information is limited and it may limit the study. (2) the information available may not be the one the researcher is looking for, (3) the timing of retrieval of information between diagnosis, treatment, and discharge. (4) there might be bias in the information record or the information available is out of date. However, (5) with the established pattern, sometimes, it can risk treatment. In other word, the patient is treated based on the recorded pattern or history while the patient is indeed suffering from different ailment. Michel (2002) argues that this system has cost associated and the information tends to be limited. Another weakness in this data system is that it can be too costly and because the data is different from one state or one district to another, vary between districts, and non-comparable, there will likely be an effort to generalize or equalize the data. This makes it impossible because each district has its own geography and characteristics or that no district is equal, so is the case of diseases. References Covey, Stephen. Setting Health Priorities and Establishing Objectives. Retrieved May 13, 2008 from http://www.healthypeople.gov/state/toolkit/priorities.htm Dailey, L.; Watkins, R. E.,; Riley, T. V. and Plant, A. J. (2007, March). The potential of pre-diagnostic data sources for influenza surveillance. Australian Infection Control, Volume 12 (1). Department of Health and Human Services – USA (2004, December). Promising Practices in MCH needs Assessment. Retrieved May 12, 2008 from hrsa.com. Earle, S., Lloyd, C. E., Sidell, M. and Spurr, S. Eds. (2007). Theory and research in promoting public health. Digital Edition. London, UK: Sage Publication. Earle, S. Chapter 1: Promoting public health: exploring the issues. Earle, S., Lloyd, C. E., Sidell, M. and Spurr, S. Eds. (2007). Theory and research in promoting public health. Digital Edition, p. 1 – 36. London, UK: Sage Publication. Earle, S. and O’Donnell, T. Chapter 3: The factors that influence health. In Earl, Lloyd, Siddel & Spurr (2007). Theory and research in promoting public health. Digital Edition, p. 67 – 100. London, UK: Sage Publication. Fleckenstein, L. E. (2006). Greening To Promote Urban Health: Strategies For Environmental Health Promotion Interventions. A Thesis. University of Pittsburgh Improving Health Outcomes (1997, September). Case studies on how English health authorities use population based health oucome assessments. Volume One. Overview and abstracts. Retrieved May 13, 2008 from http://www.nchod.nhs.uk/NCHOD/FUstudy.nsf/0/9c516726657c307365256ccd0047f51b!OpenDocument&ExpandSection=5.3,5.1,7.6,7.7,7.2. Hem, C., Næss, Ø. and Strand, B. H. (2007). Social inequalities in causes of death amenable to health care in Norway Norsk Epidemiologi, 17 (1): 43-48 43 Berg, R. L. and Cassells, J. S. Editors (1992). The Second Fifty Years: Promoting Health and Preventing Disability. Chapter 14 Social Isolation Among Older Individuals The Relationship to Mortality and Morbidity. Washington, DC: National Academic Press. 243 – 261. Michel, Philippe (2002, December). Strengths and weaknesses of available methods for assessing the nature and scale of harm caused by the health system: literature review. Retrieved May 13, 2008 from http://www.who.int/patientsafety/research/P_Michel_Report_Final_version.pdf. Proctor , M. E.;  Blair, K. A.  and Davis, J. P. (1998). Surveillance data for waterborne illness detection: an assessment following a massive waterborne outbreak of Cryptosporidium infection. Epidemiology and Infection, 120: 43-54. Cambridge University Press. Retrieved May 13, 2008 from http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=39405 Roos, L.L., Roos, N. P., Fisher, E. S. & Bubolz, T. A. (1990). Modern Method of Clinical Investigation. Chapter 5: Strengths and Weaknesses of Health Insurance Data System for Assessing Outcome. Institute of Medicine, 47-65. The Partnership Child Development (1999). School Health & Nutrition: A Situation Analysis - A Participatory Approach to Building Programmes that Promote Health, Nutrition and Learning in Schools. Retrieved May 13, 2008 from http://www.schoolsandhealth.org/download-docs/situationanalysis-English-June99.doc World Bank. Chapter 5: Preparing “An Environmental Health Profile.” Retrieved May 13, 2008 from http://www.worldbank.org/afr/environmentalhealth/chapter5.pdf Read More