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Lecture

HE302 Lecture Notes - Palliative Care, National Ambient Air Quality Standards, Cancer Screening


Department
Health Sciences
Course Code
HE302
Professor
Renee Mac Phee

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Tuesday, February 26th, 2013
Frank Model of Public Health
The model was developed as a means of developing a more integrated and coordinated
public health system
Identifies the structural components of the present system as a means of synthesizing
data collection and reporting
Regardless of where the information comes from, it ensures that planning and service
delivery are based on the same “pieces”
Five components of the model:
1. Health Surveillance: The tracking and forecasting of any health event or determinant
through continuous collection of high quality data, integration, analysis and
interpretation of the data into reports, advisories, alerts and warning, and dissemination
to those who need to know (ex. influenza, gastroenteritis). Can track it by looking at how
many people are coming to the hospital for it, look at lab results, etc.
2. Disease and Injury Prevention: involves a range of interventions, including: vaccine
programs, infectious disease investigation and outbreak control, workplace health and
safety regulations, cancer screening, programs to encourage healthy behaviors.
3. Health Protection: involves inspections of restaurants, child care centers, nursing
homes and other public facilities
- Monitoring and enforcing of water and air quality standards
- Federal government PH legislations Federal Quarantine Act 1872 (oldest piece of PH
legislation)
- Environmental Protection Act, Food and Drug Act, Tobacco Act
4. Population Health Assessment: responsible for evaluating and comparing overall
trends and changes in population health status, evaluations are used to develop new and
review existing health policies and programs, determines effectiveness of health
programs, guide future policy and program decision making.
5. Health Promotion: involves strengthening community health services, establish joint
partnerships between governments and communities to solve pressing health problems,
advocate for healthy public policies including those that address the social determinants
of health
Public Health Units in Ontario
PH unit an official health agency established by a group of urban and rural
municipalities to provide a more efficient community health program, carried out by full
time, specially qualified staff
36 PH units in Ontario
Administer health promotion and disease prevention programs
Each unit is governed by the board of health, which is an autonomous corporation under
the Health Protection and Promotion Act
Administered by the medical officer of health who reports to the local board of health
The board is largely made up of elected representatives from the local municipal boards
The MOHLTC cost-shares the expenses with municipalities
Community Based Health Services
Can include:
- Doctor’s offices
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- Walk-in clinics
- Labs
- Blood donor clinics
- Cancer screening centers
- Home-based care
- Hospice care (ex. palliative care)
Home care: can be defined as an array of services provided to individuals who are
incapacitated so as to enable them to live at home
- Services vary but can include personal care (ex. assistance with bathing, dressing,
grooming), meal preparation, household cleaning, transportation, therapeutic care, the
administering of medications and other treatments
19th Century:
Virtually everyone was cared for at home, particularly those with limited financial
resources family members helped to provide care
Doctors made house calls
Middle-class and wealthy individuals were able to secure privately paid care
The very sick, regardless of SES, were often cared for in the hospital
20th Century
Emergence of doctor’s offices, hospitals, clinics, etc. saw care of individuals being
moved from the home into the community
1950’s
Change in direction…formalized, public home care programs were being introduces
1980’s
Home care programs available in all provinces and territories
Responsibility for home care services rests with the provinces and territories
Consequently services, policies, and delivery varies considerably from one area to
another
21st Century
Significant push to have people cared for at home… much like the 19th century
without the house calls from doctors
Services for nursing, homemaking, personal care, meal services are covered by the
province
Some therapeutic services (ex. physiotherapy, occupational therapy, speech, respiratory)
may be covered depending on where the client lives
Other items that may be covered include: medical equipment, supplies, minor home
repairs, home maintenance, social services (ex. friendly visiting program), respite care,
palliative care
Some provinces (NFLD and PEI) require a physician referral in order to access services
Some programs will limit the age of the individuals eligible to receive services (ex. 65+)
Some programs are restricted to those in financial need
Who uses home care?
Figures for community care are difficult to access particularly for privately paid services
Use of publicly funded or subsidized home care services in the previous year
- 65+ = 10%, 18+ = 2.5%
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