Healthcare

This document discusses various topics related to healthcare, including the Valley of Drums toxic waste site, contextual issues affecting healthcare organizations, Medicaid and Medicare in the US, and the core functions of public health. It provides insights into the challenges and initiatives in healthcare and offers a comprehensive understanding of the subject.

Running head: HEALTHCARE
Healthcare
Name of the Student
Name of the University
Author Note

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Answer: 1
Valley of Drums is a 23-acre toxic waste site located in Kentucky. It is used for the
collection of waste since 1960. The study undertaken by the United States environmental
Protection Agency (EPA) in 1979 highlighted the presence of heavy metal and high
percentage of polyachlorinated biphenyls and other 140 harmful chemical substances in that
area. Thus in 1983, EPA enlisted this place under the superfund program as the groundwater
is gradually getting contaminated due the intoxication coming from the toxic substance and
other plastic storage drums (Kim, Schieffer and Mark 2016).
At state level Kentucky Department of Natural Resource and Environmental
Protection (KDNREP) was first to highlight the Valley of Drums as the site for
environmental concern in 1967 and they documented their official report in 1975. Later EPA
responded to this report and initiated action under Clean Water Act of section 311. Under this
act, they can control further release of the waste materials and pollutants and thereby
preventing contamination of the water resources from the toxic components. EPA also took
active initiatives to eradicate at least 30% of the surface drums (Adcock 2013).
At the community level, numerous emergency or authority response branch took
active initiatives in removing the waste drums and building temporary trenches in order to
secure the surrounding unpolluted area. After the removal of the waste drums, research has
been conducted in order to test the safety quotient for ground-water in the parameter of safety
drinking and other use like bathing (Adcock 2013).
At the individual level, people who are living in the locality and neighborhood areas
became aware of the health hazards and tried to migrate to other sage place and also fought
for the land recovery. The government also issued funding to EPA and KDEP in order to

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continue their activities of effective monitoring of the groundwater and protection of the
people and other biodiversity (Adcock 2013).
Answer: 2
Three contextual issues that ca affect organization, structure and the function of the
healthcare and public health include:
a. Effective communication
b. Proper support and maintenance
c. Financial funding and informed decision-making
Effective communication
According to Pandve and Giri (2015), India has made a significant progress in
handling HIV epidemic in comparison to the other countries. The epidemic of HIV infection
in India has decreased by 57% during the tenure of 2000 to 2011 and the main reason
attributed for this is anti-retroviral therapy. However, the government of India has failed to
promote effective prevention of HIV-AIDS among the trans-gender community, orphan
children and immigrant population. The reason behind this is lack of proper communication
and disease awareness program targeted towards these groups of population (Pandve and Giri
2015). At present National Aids Control Organisation (NACO) (2019) is aiming to work on
HIV-AIDs prevention strategy through targeted intervention approach.
Proper support and maintenance
Li (2017) stated that health inequity is present among the Aboriginals and Torres
Strait Islanders of Australia and the cultural barriers are the main reasons behind the presence
of health inequity in Australian Aboriginal population. The maternal mortality rate in

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Australia during 2016 was 8.5 deaths per 100,000 women. The majority of women hail from
aboriginal community (Australian Institute of Health and Welfare [AIHW] 2018). The
maternity services in Australia lack significant percentage of aboriginal nurses and this is
reason behind lack of adequate healthcare access among Aboriginal women leading to health
inequality and death. Lack of proper Aboriginal nursing workforce reflects lack of proper
manpower support in Australia (AIHW 2018).
Financial funding and informed decision-making
According to the World Health Organization Global TB Report (2016), six countries
accounts for 60% of the world's reported cases of tuberculosis (TB) and of them India holds
the first position. Azhar (2012) highlighted that failure in the TB program in India is
attributed lack of compliance in the complete course of the DOTS (Directly Observed
Treatment Short Course) program and lack of proper funding behind circulating this live
saving medicines in rural areas of India.
Answer: 3
Medicaid in US is defined as joint federal-state program that provides nursing home
coverage and health coverage to certain groups of low-asset people who are vulnerable
towards developing complex healthcare conditions. These groups of people include pregnant
women, children, and people with disabilities and older adults who need hospital or
residential care.
Medicare in US is a national health insurance program initiated in 1966 under the
supervision of Social Security Administration and is now regulated by the Centers for
Medicare and Medicaid Services. It provides special health insurance services to the older
adults of America who are 65 years or older (Medicare.gov. 2019).

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Thus the main similarity between Medicare and Medicaid is US is both are health
insurance policy design to provide healthcare service at a subsidized rate. However, Unlike
Medicare, whose main target groups are the old adults, Medicaid covers the health insurance
of pregnant women, children and older adults. In Medicare however, the health-insurance
coverage for the older adults are not limited to the financial background of target population.
In Medicaid program, the health insurance coverage is given to low-asset people.
The states and federal government fund the Medicaid. The federal government pays
states for the share of program expenditures, known as Federal Medical Assistance
Percentage (FMAP). Each state has its own FMAP. FMAP is based on per capita income of
each state (Medicaid.gov 2019).
In Medicare Insurance, the money comes from the Medicare Trust Funds. Medicare is
paid mainly for two different trust fund accounts held by the U.S Treasury. These funds are
solely used for Medicare. The first trust fund is Hospital Insurance (HI) Trust fund and the
main source of funding is payroll taxes paid by the employees, employers and self-employed
population. The funding also comes from premiums of Medicare Part A people who are not
eligible for premium-free Part A. Another trust fund is Supplementary Medical Insurance
(SMI) Trust Fund which is authorized by Congress and from the premiums for people
enrolled under Medicare Part B (Medical Insurance) and Medicare Prescription Drug
Coverage (Part D) (Medicare.gov. 2019).
Answer: 4
For me public health is a comprehensive healthcare requirement of an individual,
which covers both the aspect of the physical and mental well-being. This personal
understanding of the public health has changed over time. Initially I used to believe that
public health is all about the physical health covering the physiological health parameters.

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However, during the course of the semester, I realized that mental health also an important
aspect of public health in order to uplift the comprehensive healthcare needs of a person.
According to Henderson, Evans-Lacko and Thornicroft (2013), mental health is a significant
public health issue worldwide. The mental health care complications constitute a significant
portion of healthcare burden worldwide. Thus, prevention and provision of comprehensive
mental healthcare facilities are crucial under public health issues.
My gain in knowledge throughout the semester about public health helped to get a
detailed perspective of the public healthcare domains in US, which further helped to me
shape my perspectives about different aspects of public health. According to Frumkin (2016),
the US Public Health Services includes Centers for Disease Control (CDC), National Institute
of Health, Food and Drug Administration, Human Resources and Service Administration,
The Alcohol, Drug abuse and Mental Health Administration and The Agency for Toxic
Substances and Disease Registry.
Answer: 5
The core function of Public Health includes
(i) Assessment
Assessment of the community healthcare needs is done through systematic collection
and assembly of the healthcare data of the community and making the information available
in the public health status of the community. The work of gathering public health data is done
in cooperation with others like members of NGOs and the data includes health status statistics
of the community, data regarding the environmental health, epidemiology and other complex
health needs. Assessment is followed by investigation of the occurrence of the health effects
and community level health hazards and development of the plan of prevention. The last

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stage of assessment is analysis of determinants of the identified healthcare needs of the
community. The analysis is defined as the process of examining the etiologic risk and the
main contributing factors behind the specific health problems (Frenk and Moon 2013).
(ii) Policy development
Policy development includes advocacy of the public health and building of
constituencies and identification of the resources in the community. This will be followed by
prioritizing of the healthcare needs among the community along with planning, and
development of the healthcare policy in order to address the gap in the healthcare needs
(Frenk and Moon 2013).
(iii) Assurance
The first step of assurance is management of resources and development of the
organizational structure in order to meet the priority healthcare needs of the community in the
best possible manner. The management of the resources is followed by the implementation of
the policy program at the community level by working closely with the community
healthcare practitioners. The last step include educating and informing people in order to
generate healthcare awareness and changing the healthcare beliefs (Frenk and Moon 2013).

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References
Adcock, B., 2013. Hazard and Blight: Methamphetamine Waste's Insidious Persistence and
Why the Federal Government Should Be Guided by Kentucky's Approach to Cleanse Natural
Resources. Ky. J. Equine Agric. & Nat. Resources L., 6, p.301.
Australian Institute of Health and Welfare [AIHW]. 2018. Maternal deaths in Australia 2016.
Access date: 13th March 2019. Retrieved from: https://www.aihw.gov.au/reports/mothers-
babies/maternal-deaths-in-australia-2016/contents/report
Azhar, G.S., 2012. DOTS for TB relapse in India: A systematic review. Lung India: official
organ of Indian Chest Society, 29(2), p.147.
Frenk, J. and Moon, S., 2013. Governance challenges in global health. New England Journal
of Medicine, 368(10), pp.936-942.
Frumkin, H., 2016. Urban sprawl and public health. Public health reports.
Henderson, C., Evans-Lacko, S. and Thornicroft, G., 2013. Mental illness stigma, help
seeking, and public health programs. American journal of public health, 103(5), pp.777-780.
Kim, G., Schieffer, J. and Mark, T., 2016. Measuring the Impacts of the Superfund Sites in
Jefferson County, Kentucky by using a Spatial Hedonic (No. 1376-2016-109768).
Li, J.L., 2017. Cultural barriers lead to inequitable healthcare access for aboriginal
Australians and Torres Strait Islanders. Chinese Nursing Research, 4(4), pp.207-210.
Medicaid.gov. 2019. Medicaid. Access date: 13th March 2019. Retrieved from:
https://www.medicaid.gov/medicaid/index.html

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Medicare.gov. 2019. How is Medicare Funded. Access date: 13th March 2019. Retrieved
from: https://www.medicare.gov/about-us/how-is-medicare-funded
National Aids Control Organisation (NACO). 2019. Prevention Strategies. Access date: 13th
March 2019. Retrieved from: http://naco.gov.in/prevention-strategies
Pandve, H.T. and Giri, P.A., 2015. HIV/AIDS prevention and control in India: Achievements
and future Challenges. North American journal of medical sciences, 7(12), p.575.
World Health Organization [WHO]. 2016. World Health Organization Global TB Report.
Access date: 13th March 2019. Retrieved from:
https://www.who.int/tb/publications/global_report/en/