ABSTRACT
The Patient Protection and Affordable Care Act, which was enacted by the US Congress in 2010, marks the greatest change in US health policy since the 1960s. The law is intended to address fundamental problems within the US health system, including the high and rising cost of care, inadequate access to health insurance and health services for many Americans, and low health-care efficiency and quality. By 2019, the law will bring health coverage--and the health benefits of insurance--to an estimated 25 million more Americans. It has already restrained discriminatory insurance practices, made coverage more affordable, and realised new provisions to curb costs (including tests of new health-care delivery models). The new law establishes the first National Prevention Strategy, adds substantial new funding for prevention and public health programmes, and promotes the use of recommended clinical preventive services and other measures, and thus represents a major opportunity for prevention and public health. The law also provides impetus for greater collaboration between the US health-care and public health systems, which have traditionally operated separately with little interaction. Taken together, the various effects of the Patient Protection and Affordable Care Act can advance the health of the US population.
Subject(s)
Accountable Care Organizations , Health Care Reform , Insurance Coverage , Insurance, Health , Patient Protection and Affordable Care Act , Public Health , Accountable Care Organizations/economics , Accountable Care Organizations/organization & administration , Accountable Care Organizations/trends , Environment , Health Care Costs , Health Care Reform/economics , Health Care Reform/legislation & jurisprudence , Health Services Accessibility/economics , Health Services Accessibility/legislation & jurisprudence , Humans , Insurance Coverage/economics , Insurance Coverage/legislation & jurisprudence , Insurance, Health/economics , Insurance, Health/legislation & jurisprudence , Medicare/economics , Medicare/organization & administration , Medicare/trends , Primary Prevention/economics , Primary Prevention/legislation & jurisprudence , Public Health/economics , Public Health/standards , Public Health/trends , Residence Characteristics , United StatesABSTRACT
Violence is a major cause of morbidity and mortality among adolescents. We conducted serial focus groups with 30 youth from a violence prevention program to discuss violence in their community. We identified four recurrent themes characterizing participant experiences regarding peer decision-making related to violence: (1) youth pursue respect, among other typical tasks of adolescence; (2) youth pursue respect as a means to achieve personal safety; (3) youth recognize pervasive risks to their safety, frequently focusing on the prevalence of firearms; and (4) as youth balance achieving respect in an unsafe setting with limited opportunities, they express conflict and frustration. Participants recognize that peers achieve peer-group respect through involvement in unsafe or unhealthy behavior including violence; however they perceive limited alternative opportunities to gain respect. These findings suggest that even very high risk youth may elect safe and healthy alternatives to violence if these opportunities are associated with respect and other adolescent tasks of development.
Subject(s)
Decision Making , Violence/psychology , Adolescent , Connecticut , Female , Focus Groups , Humans , Male , Peer Group , Psychology, Adolescent , Violence/prevention & control , Young AdultABSTRACT
Over the last three decades, there has been increasing interest in the role that faith-based organizations (FBOs) can play in promoting health and health care access among underserved populations. Although the research literature on church-based health interventions is growing, there are relatively few rigorous evaluations of their effectiveness in addressing health and health care outcomes. Establishing a national faith-based health research network is an excellent opportunity to create an evaluative infrastructure and generate new research on health programs and their effectiveness in FBO settings.
