Organized interventions to improve health based on the principles and procedures developed through the health sciences are delivered among practitioners trained in medicine, nursing, nutrition, pharmacy, social work, psychology, physical therapy and other health care professions. Clinical practitioners focus mainly on the health of individuals, while public health practitioners consider the overall health of communities and populations. Workplace wellness programs are increasingly adopted by companies for their value in improving the health and well-being of their employees, as are school health services to improve the health and well-being of children.
Maintaining health
Achieving and maintaining health is an ongoing process, shaped by both the evolution of health care knowledge and practices, as well as personal strategies and organized interventions for staying healthy.
Self care strategies
Personal health depends partially on the active, passive, and assisted cues people observe and adopt about their own health. These include personal actions for preventing or minimizing the effects of a disease, usually a chronic condition, through integrative care. They also include personal hygiene practices to prevent infection and illness, such as bathing and washing hands with soap; brushing and flossing teeth; storing, preparing and handling food safely; and many others. The information gleaned from personal observations of daily living - such as about sleep patterns, exercise behavior, nutritional intake, and environmental features - may be used to inform personal decisions and actions (e.g., "I feel tired in the morning so I am going to try sleeping on a different pillow"), as well as clinical decisions and treatment plans (e.g., a patient who notices his or her shoes are tighter than usual may be having exacerbation of left-sided heart failure, and may require diuretic medication to reduce fluid overload).
Personal health also depends partially on the social structure of a person's life. The maintenance of strong social relationships, volunteering, and other social activities have been linked to positive mental health and even increased longevity. One American study among seniors over age 70 found that frequent volunteering was associated with reduced risk of dying compared with older persons who did not volunteer, regardless of physical health status. Another study from Singapore reported that volunteering retirees had significantly better cognitive performance scores, fewer depressive symptoms, and better mental well-being and life satisfaction than non-volunteering retirees
Prolonged psychological stress may negatively impact health, and has been cited as a factor in cognitive impairment with aging, depressive illness, and expression of disease. Stress management is the application of methods to either reduce stress or increase tolerance to stress. Relaxation techniques are physical methods used to relieve stress. Psychological methods include cognitive therapy, meditation, andpositive thinking which work by reducing response to stress. Improving relevant skills, such as problem solving and time management skills, reduces uncertainty and builds confidence, which also reduces the reaction to stress-causing situations where those skills are applicable.complete health information
Determinants of health
Generally, the context in which an individual lives is of great importance on health status and quality of life. It is increasingly recognized that health is maintained and improved not only through the advancement and application of health science, but also through the efforts and intelligent lifestyle choices of the individual and society. According to the World Health Organization, the main determinants of health include the social and economic environment, the physical environment, and the person's individual characteristics and behaviors.
More specifically, key factors that have been found to influence whether people are healthy or unhealthy include:]
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An increasing number of studies and reports from different organizations and contexts examine the linkages between health and different factors, including lifestyles, environments, health care organization, and health policy - such as the 1974 Lalonde report from Canada; theAlameda County Study in California; and the series of World Health Reports of the World Health Organization, which focuses on global health issues including access to health care and improving public health outcomes, especially in developing countries.
The concept of the "health field", as distinct from medical care, emerged from the Lalonde report from Canada. The report identified three interdependent fields as key determinants of an individual's health. These are:
- Lifestyle: the aggregation of personal decisions (i.e. over which the individual has control) that can be said to contribute to, or cause, illness or death;
- Environmental: all matters related to health external to the human body, and over which the individual has little or no control;
- Biomedical: all aspects of health, physical and mental, developed within the human body as influenced by genetic make-up.
Focusing more on lifestyle issues and their relationships with functional health, data from the Alameda County Study suggested that people can improve their health via exercise, enough sleep, maintaining a healthy body weight, limiting alcohol use, and avoiding smoking. The ability to adapt and to self manage have been suggested as core components of human health.
The environment is often cited as an important factor influencing the health status of individuals. This includes characteristics of the natural environment, the built environment, and the social environment. Factors such as clean water and air, adequate housing, and safe communities and roads all have been found to contribute to good health, especially the health of infants and children. Some studies have shown that a lack of neighborhood recreational spaces including natural environment leads to lower levels of personal satisfaction and higher levels of obesity, linked to lower overall health and well being. This suggests the positive health benefits of natural space in urban neighborhoods should be taken into account in public policy and land use.
Genetics, or inherited traits from parents, also play a role in determining the health status of individuals and populations. This can encompass both the predisposition to certain diseases and health conditions, as well as the habits and behaviors individuals develop through the lifestyle of their families - also referred to as the "nature versus nurture" debate, in other words the role of factors which can or cannot be controlled. For example, genetics may play a role in the manner in which people cope with stress, either mental, emotional or physical.
The United States life expectancy of 78.3 years at birth is ranked 36th among 194 United Nations member states; while above the world average, it falls short of the overall figure in Western Europe. Increasing obesity in the United States and health improvements elsewhere have contributed to lowering the country's rank in life expectancy from 1987 to 2007, from 11th to 42nd in the world.] The infant mortality rate of 6.37 per thousand places the United States 42nd out of 221 countries, above average but behind all of Western Europe.]Approximately one-third of the adult population is obese and an additional third is overweight; the obesity rate, the highest in the industrialized world, has more than doubled in the last quarter-century.Obesity-related type 2 diabetes is considered epidemic by health The U.S. health care system far outspends any other nation's, measured in both per capita spending and percentage of GDP.[The World Health Organization ranked the U.S. health care system in 2000 as first in responsiveness, but 37th in overall performance.
Health care coverage in the United States is a combination of public and private efforts, and is notuniversal as in all other developed countries. In 2004, private insurance paid for 36% of personal health expenditures, private out-of-pocket payments covered 15%, and federal, state, and local governments paid for 44%. In 2005, 46.6 million Americans, 15.9% of the population, were uninsured, 5.4 million more than in 2001. The main cause of this rise is the drop in the number of Americans with employer-sponsored health insurance. The subject of uninsured and underinsured Americans is a major political issue. A 2009 study estimated that lack of insurance is associated with nearly 45,000 deaths a year. In 2006, Massachusetts became the first state to mandate universal health insurance. Federal legislation passed in early 2010 will create a near-universal health insurance system around the country by 2014.
Health care in the United States is provided by many separate legal entities. Health care facilities are largely owned and operated by the private sector. Health insurance is now primarily provided by the government in the public sector, with 60-65% of healthcare provision and spending coming from programs such as Medicare, Medicaid, TRICARE, the Children's Health Insurance Program, and the Veterans Health Administration.
The U.S. Census Bureau reported that a record 50.7 million residents (which includes 9.9 million non-citizens) or 16.7% of the population were uninsured in 2009. More money per person is spent on health care in the USA than in any other nation in the world, and a greater percentage of total income in the nation is spent on health care in the USA than in any United Nations member state except for East Timor. Although not all people are insured, the USA has the third highest public healthcare expenditure per capita, because of the high cost of medical care in the country.[clarification needed] A 2001 study in five states found that medical debtcontributed to 46.2% of all personal bankruptcies and in 2007, 62.1% of filers for bankruptcies claimed high medical expenses. Since then, health costs and the numbers of uninsured and underinsured have increased.[8]
Active debate about health care reform in the United States concerns questions of a right to health care, access, fairness, efficiency, cost, choice, value, and quality. Some have argued that the system does not deliver equivalent value for the money spent. The USA pays twice as much yet lags behind other wealthy nations in such measures as infant mortality and life expectancy, though the relation between these statistics to the system itself is debated. Currently, the USA has a higher infant mortality rate than most of the world's industrialized nations. In the United States life expectancy is 42nd in the world, after some other industrialized nations, lagging the other nations of the G5 (Japan, France, Germany, UK, USA) and just after Chile (35th) and Cuba (37th).
Life expectancy in the USA is 42nd in the world, below most developed nations and some developing nations. It is below the average life expectancy for the European Union. TheWorld Health Organization (WHO), in 2000, ranked the U.S. health care system as the highest in cost, first in responsiveness, 37th in overall performance, and 72nd by overall level of health (among 191 member nations included in the study). The Commonwealth Fund ranked the United States last in the quality of health care among similar countries, and notes U.S. care costs the most.
