W.H.O. DEFINITION OF PRIMARY CARE Point of Entry Patients must be referred by their primary care physicians before visiting specialists or seeking admission into a hospital. Coordination of Care The provider: refers patients to sources of specialized care, gives advice regarding various diagnoses and therapies, discusses treatment options, and provides continuing care for chronic conditions Essential Care The goal of the health care delivery system is to optimize population health, not just the health of individuals who have the means to access health services.

Black Americans Hispanic Americans Asian Americans/ Pacific Islander Are more likely to be economically disadvantaged than Whites Compared to Whites, Blacks have: Is growing at a higher rate than other population segments Face significant barriers in accessing health care: Shorter life expectancies Higher-age adjusted death rates for leading causes of death Higher age-adjusted maternal mortality rates Higher infant, neonatal, and post-neonatal mortality rates Immigrants may not qualify for Medicaid Inability to speak English to physicians Low education which leads to unemployment and thus a lack of health insurance Asian Americans/ Pacific Islander American Indians/ Alaskan Natives Constitutes one of the fastest-growing population segments in the US Are very diverse in education, income, and health status Are at the bottom of the socioeconomic strata The Indian Health Services provides comprehensive health services Independent risk factors for health care access and utilization include: Citizenship/nativity status Maternal education attainment Poverty status Have higher death rates from : Alcoholism Tuberculosis Diabetes Injuries Suicide Homicide

Certain unique aspects to consider for children’s health: Developmental Vulnerability The rapid and cumulative physical and emotional changes that characterize childhood The potential impact that illness, injury, or disruptive family and social circumstances can have on a child Dependency A child’s need for adults to take responsibility for recognizing and responding to his/her health needs New Morbidities Problems from which older generations may not suffer: Drug and alcohol abuse Family and neighborhood violence Emotional disorders Learning problems Birth or Congenital Conditions Medical problems in children are usually related to birth or congenital conditions.

Poverty and the Health Care System Homeless The homeless have higher rates of morbidity which results in greater utilization of both inpatient and outpatient services (3.5 million) Rural Health Access to health care is affected by poverty, long distances, rural topography, weather conditions and limited availability of transportation (22 million) Uninsured The uninsured are neither unemployed nor poor enough to qualify for federal programs (46 million)

Poverty and the Health Care System Homeless The homeless have higher rates of morbidity which results in greater utilization of both inpatient and outpatient services (3.5 million) Rural Health Access to health care is affected by poverty, long distances, rural topography, weather conditions and limited availability of transportation (22 million) Uninsured The uninsured are neither unemployed nor poor enough to qualify for federal programs (46 million)

How HIV/AIDS Affect the US Health Care System Cost of Treatment Discrimination Prevention Treatment Research Many efforts are being made to advance and improve HIV research, treatment and prevention. However, progress is slowed due to discrimination that HIV-positive patients may face and the high expenses of treating HIV/AIDS.