User:Gia.gatech/sandbox

=Artifact 3 Group Project=

Introduction:
Welcome to our repository site that focuses on medicine and healthcare. The goal of this site is to collect information regarding medicine, public health, and healthcare that can be edited and expanded through our time at Georgia Tech. With a field as broad as medicine, there is a seemingly endless amount of germane topics that could be added to this site. However, for the scope of this assignment, each group member individually chose two articles, two glossary terms, two programs, and two ways to engage with the field, attempting to connect the topics to establish organization and flow as well as cover the information as in depth yet concise as possible.

All the different topics that we included throughout this repository are relevant in the medical industry, and many of them have become increasingly prevalent over the past decade. The improvement of technology has accelerated the development of many fields, one of those being the healthcare industry. Different technologies have been utilized to enhance efficiency and reduce errors. The healthcare industry is extremely important. Generally, everyone goes to the doctor at least once a year to make sure they are in proper health. This shows the massive significance this industry holds, so it is of note for everyone to be somewhat knowledgeable about the medical field and the different programs and initiatives that are in place so they can receive the best care and opportunities that are applicable to them. There are many different subdivisions in the healthcare industries and the general population comes into contact with a few of those on an annual basis at the least. Those include a general healthcare practitioner, dentist, and ophthalmologist. The healthcare industry is worth close to a trillion dollars. It brings in a lot of revenue which again shows its value in the United States. Specifically, the US tends to spend twice the amount of money on healthcare compared to other countries around the world. Additionally, this field provides millions of jobs. This is one of the US’s biggest and rapidly growing industries.

Because of this importance portrayed, we hope to share varying aspects of medicine, public health, and healthcare that may be pertinent to understand even as an everyday person. By bringing in each member’s background and interest in this topic with each article, glossary term, program, and social way to engage within the field, we were able to accomplish this. For example, Social Determinants of Health are very important to understanding the basis of public health, while health insurance is a glossary term that is more general and important to healthcare. Additionally, we were able to specifically portray the different involvements of medicine through the social/cultural ways to engage and the platforms/programs. More relatable examples such as organizations on our campus were also discussed to target student audiences who are more likely to refer to this Wiki page. However, we included topics and terms for anyone and everyone interested in medicine, public health, or healthcare. For example, the Auxiliary is a volunteer organization as explained in the glossary terms and commonly consists of retired or elderly members. Moreover, the glossary terms and articles presented were more a variety of support materials provided to help understand the platforms, programs, and ways to engage. These platforms and programs, however, were initially brainstormed by our group based on our individual interest.

Overall, each of our entries into this wiki site generally fall under one of four categorizations: 1) crucial technologies, such as vaccines, 2) significant policies, like Medicare and Medicaid, 3) critical concepts within healthcare, like epidemiology and health insurance, and 4) organizations within the field, such as the American Hospital Association. We tried to cull elements from these four categories such that the resulting wiki site would give an outsider a decent overview of the healthcare field, especially in the United States, while providing a specific focus on Georgia Tech and its resources. Because healthcare is an unimaginably vast field, many important concepts, technologies, and factors were omitted from our wiki site. However, we hope that our site will encourage readers to learn more on their own afterwards, taking it up among themselves to fill the gaps and gain a more nuanced understanding of healthcare as a whole after understanding the basic context from our site. To this end, our site serves as a starting point, which provides just a few thoughtfully selected components of healthcare, but leaves the readers on their own to learn as much as they desire. In addition, we provide a quick overview of various healthcare sub-fields, such as health insurance and epidemiology, paving the way for readers to engage in further study in whichever concepts peak their interests the most.

Gia
Glossary terms:


 * Social determinants of health

According to the CDC, the social determinants of health (SDOH) are the conditions and environments that people are in that affect their overall health and quality of life. The social determinants of health can be grouped into 5 domains: economic stability, education access and quality, healthcare access and quality, neighborhood and built environment, and social and community context. Each of these domains are intertwined and contribute to the outcomes and risks in people's lives. For example, if a community does not have good education access and quality, less youth might graduate high-school, leading to less getting a college degree and making a high-paying income. Because of this, they may lack economic stability, meaning they might not be able to afford healthier foods, healthcare, and/or housing. This in turn increases the risk that they will develop diabetes, heart disease, and depression at some point in their life. The World Health Organization (WHO) has created goals called Healthy People 2030 that relate to these SDOH.


 * Chronic Diseases

Chronic diseases are defined as conditions that last more than 1 year and require ongoing medical attention and/or limit daily activities. Some examples of chronic diseases that cause the highest rate of death and disability, and contribute the most to annual healthcare costs in the U.S. are diabetes, heart disease, and cancer. While chronic diseases are incurable, they can be managed and ameliorated through medical intervention and lifestyle modifications. However, prevention is the best cure. When considering the social determinants of health, environmental factors play a crucial role in the incidence and progression of chronic illnesses. Ultimately, combating chronic diseases requires an approach that includes not only medical treatments but also broader societal changes aimed at promoting health equity and addressing the underlying causes of poor health outcomes. By prioritizing prevention and addressing the social determinants of health through policy change, we can work towards a future where chronic diseases are less prevalent and their impact is significantly reduced.

Programs:


 * Mobile Clincs

Mobile clinics give health services to people who may not have it otherwise. They are vehicles equipped with supplies and medical personnel that are able to travel and provide services to populations in need. There is an estimated 2000 mobile clinics operating in the U.S. helping vulnerable target groups and communities all over the country. In a study on Mobile Health Clinics in the U.S., 724 clinics provided information on the types of services they offer shown in the figure below.



These clinics are essential to improving health equity across the United States. 5.2 - 7.0 million visits to mobile health clinics are estimated by a combined research effort cited in the International Journal for Equity in health in association with MobileHealthMap.org, a comprehensive database of mobile health clinics across the U.S.. Assuming the lower number of 5.2 million visits, 2.1 million is estimated to be visits by children.


 * [[File:Neweprscribing.png|thumb|Sample of e-prescribing software from PKSoftware] E-prescribing

E-prescribing is a computerized prescribing system that allows a physician or other prescriber to electronically send a prescription directly to a pharmacy, reducing chances of medication error and improving healthcare quality. It revolutionizes the medication management process, benefitting both healthcare providers and patients. According to Medicare.gov, electronic prescribing saves time, money, and helps keep people safe. With the use of electronic prescribing, people do not have to take handwritten prescriptions to the pharmacy and wait for them to be filled by a pharmacist. Instead, people can simply wait until they get notified that their prescription is ready for pickup, saving time and an additional trip to the pharmacy. E-prescribers can also check which drugs are covered by an individual's insurance, and prescribe a more cost efficient option. Additionally, now that pharmacists do not rely on handwritten prescriptions that are subject to error, the chance that a person will get the wrong drug or dose is significantly reduced.

Articles pertaining to programs:


 * Mobileclinicsscreenshot.pnge 1: Scope and Impact of Mobile Clinics in U.S.

This article discusses the transformation of the U.S. healthcare system to enhance accessibility and outcomes amid escalating chronic disease burdens and healthcare costs, highlighting the disparities in healthcare access and health outcomes among certain populations, primarily attributed to inequities in healthcare access and social determinants of health. Addressing these disparities is crucial for improving national health equity and reducing healthcare expenditures. The article addresses that policymakers and healthcare professionals must devise innovative interventions to manage chronic diseases sustainably, promote preventive health measures, and enhance outcomes among marginalized communities and the general population alike.

Mobile Health Clinics (MHCs) emerge as a potential solution to mitigate health disparities among vulnerable populations and individuals struggling with chronic illnesses. The article analyzes the role of MHCs within the U.S. healthcare framework through an evaluation of sources from PubMed and MobileHealthMap.org. Findings indicate that MHCs effectively reach vulnerable populations by delivering services directly to communities in need and adapting to community health issues.


 * Source 2: Role of E-prescribing in Healthcare

This article discusses electronic prescribing (e-prescribing) and its significant advantages over manual prescription methods in hospitals through a case study at Newham University Hospital in London. It states that e-prescribing streamlines the prescription and dispensing process, enhances medication management, and improves the maintenance of medical records. It also discusses how the increasing complexity of medication use has raised the risk of errors, making e-prescribing a less error-prone alternative and provides clinicians with a more reliable source of patient medication information, saving time and improving accessibility to crucial patient data such as preferences, allergies, and medical history. The case study conducted at Newham University Hospital in London revealed widespread support through survey analysis among healthcare professionals for implementing e-prescribing systems, despite technical and economic challenges. Overall, the study emphasizes the clear benefits of e-prescribing, highlighting its potential to enhance efficiency and patient safety in healthcare settings.

Social/cultural ways to engage:


 * CHOA donor and/or volunteer

CHOA, which stands for Children's Healthcare of Atlanta, offers a great opportunity to engage with the community through a healthcare perspective. They are one of the top pediatric hospitals in the nation, specialising in pediatric care and services. Their commitment to community involvement is evident through various volunteering programs tailored for different age groups, including adults, college students, families, teens, and youths.

Volunteers play a crucial role in supporting CHOA's mission by contributing to family support services, participating in fundraising events, and more. According to CHOA, in-hospital volunteers collectively donate over 127,000 hours of their time and raise millions of dollars to aid the patients under their care. For those interested in getting involved, the CHOA website is a great way to explore volunteering opportunities. Simply visit the website and navigate to the "donors & volunteers" section to learn more and take the first step toward making a positive impact in the community.


 * Good Samaritan Health Center

The Good Samaritan Health Center is working to provide healthcare to low-income families in the Atlanta area, helping to close the healthcare gap in the community and put patients on a path of long-term wellness. Their impactful initiatives have gathered attention in various media platforms, including videos, podcasts, and articles, highlighting their efforts to enhance community well-being and public health. They also established the Good Sam Institute, an extension of their mission which facilitates collaborations among healthcare professionals, educates future healthcare practitioners, and publishes research findings. Central to their operation are volunteers, who play a vital role in supporting their endeavors. Opportunities for volunteering range from licensed medical professionals assisting at their clinic to individuals helping out on their farm, cultivating food, and participating in local farmer's markets. Additionally, they offer a competitive internship program tailored for those aspiring towards a career in medicine. To get involved visit their website and click on "get involved" to search the various volunteer opportunities they have.

Deepika
Glossary terms:

An immunization record is important to every citizen. Regardless of whether one was born in the United States or immigrated, there are certain immunizations they must receive with passing of age or for their immigration application to be approved. An immigration record is a list of all the immunizations one has received in their lifetime and the specific time they received the immunization. Immunization records promote overall good health because they ensure vaccines are being received. Vaccines are the best way to avoid getting disease. Immunization records track those vaccines and prove to employers and schools that you don’t have the possibility of getting those diseases and spreading it to others. This allows for schools and employees to guarantee they maintain a safe environment. Immunization records also help with the general health of a community by being able to verify the vaccination status of those within a community. These also help with healthcare professionals identifying which vaccines need to be given.
 * Immunization Record


 * Diagnosis

A diagnosis narrows in on the potential causes of a disease and directly identifies it. It is the key to improving a patient’s condition. The way to ameliorate the health of a patient is by finding the cause of their ailment. This allows for the best solution to be identified. A diagnosis is significant because it includes the details of a patient’s condition and this can determine the disease that they have and present a solution whether it be through medication, surgery, or a lifestyle change. A diagnosis also helps predict the future progress of a disease and the course of action that has to be taken at the current moment. In addition, the correct diagnosis results in proper resource allocation. The needed equipment and medicine can be deployed in a timely manner. This is cost effective because a speedy and accurate diagnosis prevents additional expensive tests from being done and saves valuable time that could go into the treatment plan of a patient.

Programs:


 * Electronic Healthcare Records System

The Electronic Healthcare Records System is a system that digitizes a patient’s healthcare records. It updates in real-time and includes all the information that would be a part of the patient’s charts on paper. This streamlines the process of finding information and makes it a lot easier for the files of patients to be viewed. The entire medical history of a patient is stored in one location so it’s a lot easier for doctors to get the information they need. The Electronic Health Record includes the current medications a patient is on as well as their immunization record, diagnoses, treatment plans, and allergies. This reduces the possibility of any errors occurring and it boosts efficiency. As this technology is still somewhat in its infancy, there are still a few concerns with using the Electronic Healthcare Records System. One of those concerns is the data security strength the system has. This system serves to make a patient’s records more accessible to doctors but this also leads to a patient’s information being more at risk as it can be accessed by anyone who has the authority but is not directly involved with the patient. The Children's Health Insurance Program is a program that was established to ensure children have access to healthcare. Although programs like Medicaid do provide healthcare to children in low income families, it does not cover children whose families make too much to qualify for medicaid but still too little to where they struggle with making the healthcare payments and cannot afford proper healthcare insurance for their children. Not only does this reduce the financial burdens and struggles of those low income families, it reduces the healthcare disparities among children in the community as a whole. This program generally covers the cost of doctor's visits, immunizations, and some hospitalization costs.
 * Children's Health Insurance Program

This plays an important role in a child’s health and wellbeing so this program is advocated by most policymakers. Tens of billions of dollars has been allocated towards this policy which shows the emphasis the government is placing on children’s healthcare. This act was officially passed in 1997 in order to provide insurance to the millions of children who did not have it. Over the years, the act has been expanded upon to include additional regulations and funding.

Articles pertaining to programs:


 * Source 1 : Issues in the US Healthcare System

This article explores the issues pervading the current US healthcare system. It delves into the different factors that contribute to the present dilemmas that prevail in the medical industry. One of the most predominant issues is the massive commodification the industry has traversed to. The market is formatted in such a way that every minor inquiry has a price associated with it. The interactions that take place are with the monetary interests of the healthcare provider rather than the wellbeing of the patient being of the utmost importance. Another plight this article closely examines is the lack of communication that takes place between different healthcare professions. This causes for tests to be unnecessarily run again and it causes diagnoses to take much more time than needed. This article identifies the current drawbacks in the system through past events and statistics and comes up with a set of solutions to address those impediments. Overall, the industry is not efficient. The requirement for specialized doctors to get referrals from hospitals for patients and hospitals have to expend an exorbitant fortune to hire specialists specifically for their hospital is a huge hassle in itself. Through making processes more streamlined and communication easier, there will be a better outcome for both the doctors and the patients.

This paper scrutinizes the drawbacks to the electronic health records system. It recognizes that there are several issues in using this system to log the records of patients. Due to these difficulties, healthcare providers are not completely open to using the electronic health records system. A study shows that even though the electronic health records systems eases the access to information and makes different processes more efficient, there were still undesired and unintended cognitive impacts that resulted.
 * Source 2 : Implementation Problems with Electronic Healthcare Records System

The user interface of the electronic health records system is not very friendly and the information was typically fragmented or carelessly inputted. There is work in progress to combat these issues, but the key plight is that the solutions in  place to fix this are oriented towards improving individual cognition rather than team cognition. This makes collaborative work, very necessary for clinical work as medical cases run through teams working together to cure a patient, still difficult. Furthermore, there’s no concrete response to confirm that information has been updated through the electronic health records system which could lead to potential miscommunication.

Social/cultural ways to engage:


 * American Hospital Association

The American Hospital Association is an organization that aims to influence healthcare on a macroscopic level through serving as an advocate for healthcare related policies and legislation. The AHA also serves to strengthen the skills of hospital workers through providing training as well as offering resources and promoting hospital recruitment. AHA also focuses on lowering the social disparity that exists within communities and to allow everyone equal access to health equity. Anyone with a passion or interest in healthcare advocacy can become a member of the American Hospital Association. The AHA includes both institutional members which comprise of hospitals and professional membership groups which are organized by different professions and where each group can get the resources tailored for their development. The American Hospital Association additionally works toward improving the quality of hospitals. They support initiatives that reduce patient infection rates, the transition of patients between care, and the readmission rate of patience.


 * Emory Volunteering

The Emory Volunteering program is set up to give an opportunity to the community to volunteer at the Emory hospital. The Emory Hospital filters through tens of hundreds of patients every day. There is a significant amount of manpower that is required to give every patient the thorough help and care they deserve. The volunteers at the Emory Hospital go through an application process as well as a training period. These requirements ensure that volunteers can offer the proper assistance as necessary. In addition, it’s a way for members of the community to give back as well as exercise their interpersonal ability. There are various types of roles volunteers can have which include but are not limited to delivering mail, transporting patients, serving food, and greeting patients and their families. Volunteers are not only able to offer support to patients, they also ease the moods of accompanying family members. The Emory Volunteering program has different subprograms, one of which is for adults and the other is for teenagers. These programs were set up since the 2000s and serve as a great way to obtain hospital volunteer experience.

Helen
Glossary terms:

Health insurance is an agreement for an insurance company to pay for a portion or all of one’s medical fee in exchange for a monthly payment. For this reason, it is important to stay in good financial standing in order to pay for medical bills. Everyone needs health insurance as it offsets the costs of minor medical issues and major medical issues such as surgeries and life threatening treatments. Health insurance can be obtained in various ways for a variety of situations. For example, if you are employed, employers may offer health insurance as a part of employee benefits, although you may have to pay a portion of the fee. Self employers can purchase health insurance through federal or the Health Insurance Marketplace. Low income families or individuals can also qualify for subsidized coverage with the Medicaid or Medicare program. The cost of health insurance varies based on the plan, scope of coverage, age, and more.
 * Health Insurance

By definition, an auxiliary is a person or thing that gives aid of any kind such as a helper. In hospital or medical context, an auxiliary is an organization of volunteers that aid and work with hospitals. An auxiliary can offer opportunities to help patients and staff while supporting the services both directly and indirectly that the hospital or clinic provide. Every member of an auxiliary is alike as every volunteer can contribute different skills and backgrounds, while also each having unique interests. Each volunteer contributes to the Auxiliary and the community in various different ways. Some examples may include baking, helping with fundraisers, assisting patients and visitors, and helping at an admissions desk or in a gift shop. Auxiliary nurses are specific healthcare providers who assist other nurses and healthcare providers. They can work in hospitals, clinics, or nursing homes. Nursing auxiliaries will also wear uniforms, gloves, and face masks as they are working in a clinical environment.
 * Auxiliary

Articles:


 * Source 1: The Impact of Health Insurance on Health

This paper reviewed evidence on the impact of health insurance on human health and reached three main conclusions. The first conclusion reached was the correlation between health insurance and human health may be driven by outside and unobservable variables. This was because studies that claim to reveal the causal effect between the two factors do not usually do a convincing job. The second conclusion was that most evidence that demonstrates the benefits of health insurance on health are focused on subgroups that would likely be targets to insurance fee coverage expansion policies. The third conclusion reached was that the generalization of these studies must be analyzed because of policy reasons. Overall, the challenges of establishing causal relationships between the two factors are emphasized. A quasi or social experiment is needed to provide more credible evidence. The authors suggest that while health insurance is mostly beneficial to vulnerable populations such as children, it is not shown to be as beneficial for other populations like near elderly.


 * Source 2: The Interchangeability of Paid Staff and Volunteers in Nonprofit Organizations

This paper discusses the interchangeability of volunteers and paid staff in hospitals and non profit organizations. The data of the study was drawn from national surveys and hospital case studies. These series of studies were done in Canada. The conclusions made were that complex patterns were found to reveal volunteers replacing paid staff and visa versa. Most organizations acknowledge that paid and volunteer work can be swapped, but this applied to only 12% of tasks within the organizations. The article also discusses the meaning of these conclusions, suggesting a model to help understand how paid and volunteer roles can switch. Additionally, the study excluded board volunteering from the discussion on swapping volunteer and paid roles because this did not apply to paid staff jobs. Spearman's rho was also used because a Likert scale was applied to measure the agreements from surveys with statements of swapping volunteer and paid work, allowing for ordinal data.

Programs:


 * Georgia Tech Health Insurance

The Georgia Institute of Technology offers a student health insurance program (SHIP), which is available for enrolled graduate and undergraduate students. The program is also open for eligible dependents that do not have health insurance. This plan has all inclusive benefits that range from medical, dental, vision, and prescription medicine to worldwide travel. There are two types of health insurance: mandatory and voluntary. Mandatory health insurance is for students charged for insurance along with their tuition. This includes students enrolled in programs requiring proof of insurance, which are mainly graduate students with APPH majors or in the CHBE and BMED programs. Additionally, as mentioned before, dependents such as spouses or children can be added to this plan as per the United Healthcare Student Resources. There is an open enrollment during fall and spring/summer with rates varying from $1,252.69 for mandatory individual students to $1,731.69 for voluntary individual students per semester.

The Affordable Care Act (ACA) contains tax provisions that change how individuals and families file taxes. These support comprehensive health insurance reforms that can also affect organizations, business, employers, and more. For individuals and families, the ACA requires health care coverage and may also provide premium tax credit for coverage purchased from the Health Insurance Marketplace. Premium tax credits are subsidies that lower costs for households within the federal poverty level. For employers, the ACA requires health care coverage with specifics determined by the size and structure of the workplace. Additionally, this act or health care reform law was enacted in 2010 and is also referred to as PPACA or Obamacare. The goal of this law was to expand the Medicaid program and cover all adults with low income. This also included making health insurance more affordable and available overall. The act will conclusively support innovative medical care delivery to lower health care costs in general.
 * Affordable Care Act

Social/cultural ways to engage:


 * GT SHS Ambassadors

Georgia Tech Stamps Health Service (SHS) Ambassadors is an application based student led organization at Georgia Tech that works with the healthcare providers at Stamps Health Services on campus. SHS Ambassadors provides SHS with volunteer services with GT pre-health students, who are in return provided volunteering, networking, educational, and shadowing opportunities. General members are required to commit at least three points per semester (each point is equivalent to around an hour). The organization has five committees including Mental Health, College Prevention Project, Women’s Health, Nutrition and General Wellness, and Sexual Health. Each committee holds its unique events every semester. Some examples of popular events students can get involved in include Stamp’s flu and COVID vaccination clinics, QPR training, pet therapy events, Red Ribbon tabling, and food drives. New members are accepted at the start of every semester. Joining this organization provides benefits, allowing students to be involved in campus initiatives, have an impact on campus community, and gain leadership skills from volunteering and leading events.


 * Northside Volunteer

Northside Hospital has a volunteer program of auxiliary volunteers that provide opportunities for involvement in community and experiences in healthcare with new skills and friendships. Northside Hospital Auxiliary volunteers interact with patients and families in departments throughout the hospital. Volunteer activities may involve assisting with photos of newborns, working in a gift shop, delivering flowers, transporting patients in the hospital, assisting or supporting patient families, helping at the information desks, shuttling between the hospitals and parking, and more. More unique opportunities include performing puppet shows in elementary schools and offering support to patients in Northside’s Cancer Institute and involvement for cancer awareness. There are hospital auxiliaries located in Atlanta, Cherokee, Duluth, Forsyth, and Gwinnett. Joining the auxiliary helps patients, families, and staff, and volunteers can meet great people while sharing their skills. Volunteering will enrich one’s life with fulfillment and enjoyment of companionship of similar people Northside volunteers will “Be the difference.”

Jaisen
Glossary terms:


 * Vaccination

Vaccines are typically injections that stimulate a certain immune response within the body to counter specific infections or diseases. They usually contain a dead or weakened form of the disease-causing substance. As a result, when someone is administered a vaccine, they do not fall seriously ill, but their immune system reacts as if they received a live, dangerous pathogen. This causes it to produce antibodies that target the specific pathogen that was in the vaccine. As a result, the body gains some measure of immunity for that specific pathogen. If, later on, live and strong germs of the same pathogen entered the body, the body would “remember” this pathogen, and it would already have antibodies that can target and eliminate it. Edward Jenner created the first vaccine against Smallpox in 1796. Since then, vaccines for many other diseases have been made, including Rotavirus, Mumps, Polio, Measles, and many more. It is estimated that, each year, four million deaths are prevented by vaccines, making it one of the most important healthcare inventions.


 * Epidemiology

Epidemiology is defined as the “study of distribution and determinants of health-related states among specified populations and the application of that study to the control of health problems,” according to A Dictionary of Epidemiology. In simpler terms, it usually refers to the study of how and why certain diseases occur in and affect certain groups of people. Epidemiology is a crucial field because it allows people to form strategies to combat the spread of current diseases and prepare for new ones. Epidemiology can be broken down into different categories, including infectious disease epidemiology for public health, which involves detecting and tracing pathogens such as COVID-19, chronic disease epidemiology, which is focused on chronic diseases like cancer and diabetes, environmental epidemiology, which deals with how environmental factors, like pollution and nutrition, affect people's health, and violence and injury epidemiology, which addresses how injuries like those in car crashes affect people. Oftentimes, epidemiologists work to determine what governmental policies and responses are best suited to improve public health.

Articles:


 * Source 1: Vaccines: past, present and future

This paper is written by Dr. Stanley A Plotkin, a scientist who made significant contributions to vaccines in the 20th century. His paper overviews vaccines and their history, starting hundreds of years ago with the practice of variolation. Variolation involves transferring a small amount of infected material, usually infected with smallpox, to an uninfected person. This in turn would give the uninfected person a greater amount of immunity to the disease. Dr. Plotkin states that it is not certain whether the practice of variolation originated from China, India, or some other place, but after it was discovered, it spread around the world and soon became common practice. The paper fasts forward hundreds of years and discusses some of the pivotal advancements in vaccines of the 20th century. Among these are the advent of virus vaccine technology and new vaccine capabilities through genetic engineering. Towards the end of the paper, Dr. Plotkin discusses other vaccine strategies such as incorporating multiple vaccines into one. He also discusses problems for the future of vaccines, such as the high cost to develop which lies in the hundreds of millions of dollars. This issue is especially evident when focusing on vaccines that primarily help developing countries. To this end, Dr. Plotkin states that organizations like the Bill and Melinda Gates Foundation have proven to be extremely helpful, but are not a complete solution on their own.


 * Source 2: A Future for Epidemiology?

This article discusses epidemiology and its future. It addresses criticism for the current approach towards epidemiology. In response, it outlines a paradigm to guide epidemiology into a future era. The paper starts off by stating that recent advancements in epidemiology have been made, but professional dissatisfaction exists nonetheless. Some of this dissatisfaction is a result of issues regarding a lack of strict scientific rigor and an excess of bias and confounding, and issues with epidemiological hypothesis testing. Other critiques of current epidemiology, according to the article, lie in how current epidemiology often fails to account for interactions among individuals and interactions between individuals and the environment. On this front, more social and environmental context could improve the field of epidemiology. The new paradigm for epidemiology that the article proposes includes a greater amount of attention paid towards all levels of societal organization with regards to the spread of disease. It also includes taking a historical approach to understanding and solving current problems.

Programs:


 * Medicare

In 1965, the Social Security Amendments of 1965, or the Medicare and Medicaid Act, was signed by president Lyndon B. Johnson. Within this act was Medicare, a social program that helps the elderly. At the time, and nowadays as well, health insurance was often linked with employment. As a result, elderly people who were retired were sometimes unable to access adequate health insurance affordably. Medicare provides these people with federal health insurance. In the decades since its creation, Medicare has gone through various changes. At first, it solely helped those aged 65 and above. This was later reformed to include people with disabilities and specific conditions. Another change came about in 1997 when the Medicare Plus Choice program was created. This was later renamed to the Medicare Advantage Plan in 2003. This new plan allowed people to enroll in healthcare plans from outside companies that the government approved. Oftentimes, Medicare Advantage Plans include other services not traditionally included in standard Medicare.


 * Medicaid

Medicaid is the other extensive social program created from the Social Security Amendments of 1965. It provides healthcare to over 70 million Americans, and is larger than every other source of healthcare in the United States. Its purpose was to provide sufficient healthcare for the most economically disadvantaged Americans. Medicaid was not adopted by each state when it was first created, but by the 1980s, each state had embraced it. While Medicaid policies vary from state to state, low-income individuals and families, pregnant women and children, individuals with a Supplemental Security Income (SSI), and certain individuals with disabilities are generally covered under Medicaid. The Affordable Care Act of 2010 significantly expanded Medicaid to include more low-income people and to increase the number of children who qualify for Medicaid. People who receive Medicaid from a certain state are usually residents of that state and can either be US citizens or certain qualified non-citizens. In the United States, Medicaid covers about 40% of births, almost half of kids with special care needs, over half of nursing homes, almost a quarter of adults under 65 with mental illnesses, and about 40% of adults under 65 with HIV.

Social/cultural ways to engage:


 * National Union of Healthcare Workers

The National Union of Healthcare Workers is based in Oakland, CA. It was formed in 2009 and today represents over 19,000 healthcare workers in California. It used to be a part of the Service Employees International Union (SEIU) but split apart due to issues regarding the leadership of SEIU United Healthcare Workers West (SEIU-UHW). Some of their main initiatives focus on promoting mental health, enforcing safe staffing, securing raises, and reducing managerial abuse for healthcare workers. Another goal of the National Union of Healthcare Workers is to reduce racism within healthcare. Members include a diverse array of professions, including psychologists, medical technicians, pharmacists, housekeepers, clerical workers, dietary workers, drug rehabilitation counselors, nurses, nursing assistants, mental health clinicians, engineers, and more. The National Union of Healthcare Workers is funded by dues that members pay. These dues are 1.5 percent of a member’s wages. Sal Rosselli is the current president of the union, and he helped found it in 2009.


 * American Nurses Association

The American Nurses Association, or ANA, was founded in 1896 and serves to promote nurses and the nursing profession in the United States. The ANA advocates for a variety of healthcare and nursing-related issues, including Medicare reform, safe nurse staffing, workplace violence, health care worker whistleblower protection, and reimbursement for health care services. To promote its objectives, the ANA participates in political lobbying and provides many career development resources to healthcare workers. Nurses in the United States may become members, and members have many benefits including access to resources and webinars, access to current nursing news, a network of other nurses to interact with, extra state benefits from being part of a nurse association, and more. Students who are not registered nurses can also benefit and contribute to the American Nurses Association by becoming ANA Student Subscribers. This will allow them to learn more about nursing professions and gain access to more healthcare resources. Other non-students can become ANA Subscribers to receive similar benefits.