National Health Service increases

In a prospective study of over 900,000 adults in the USA, increased BMI was associated with increased death rates from all cancers combined, as well as for cancers at multiple specific sites." The authors of this study estimated that obesity and overweight in the USA could account for 14% of all deaths from cancer in men and 20% in women. As well as the substantial human cost from obesity-associated disease and premature mortality, obesity has serious consequences for the economy. In the UK, it has been estimated that obesity leads to 18 million sick days a year, 40,000 lost years of working life and shortening of life by 9 years on average. Treatment costs to the National Health Service are of the order of 0.5 billion a year and the impact on the wider economy may be as high as 2 billion. ... 

Approximately a third of stroke survivors are functionally dependent at one year and stroke is the commonest cause of neurological disability in the developed world (Murray and Lopez 1996 MacDonald et al. 2000). Stroke also causes secondary medical problems, including dementia, depression, epilepsy, falls and fractures. In the UK, the costs of stroke are estimated to be nearly twice those of coronary heart disease (British Heart Foundation Statistics Database 1998 Rothwell 2001), accounting for about 6% of total National Health Service (NHS) and Social Services expenditure (Rothwell 2001). As the population ages over the coming two decades, the total stroke rate will probably increase unless there are substantial decreases in age- and sex-specific incidence (Rothwell et al. 2004a). Stroke deaths are projected to increase from 4.5 million worldwide in 1990 to 7.7 million in 2020, when stroke will account for 6.2% of the total burden of illness (Bonita 1992 Sudlow and Warlow 1997 Menken et al. 2000). 

J Consult Clin Psychol 61 1100—1104, 1993 Stephens RS, Roffman RA, Simpson EE Treating adult marijuana dependence a test of the relapse prevention model. J Consult Clin Psychol 62 92—99, 1994 Stephens RS, Roffman RA, Curtin L Comparison of extended versus brief treatments for marijuana use. J Counsul Clin Psychol 68 898—908, 2000 Substance Abuse and Mental Health Services Administration The BASIS Report Marijuana Treatment Admissions Increase 1993-1999. Rockville, MB, Substance Abuse and Mental Health Services Administration, 2002a Substance Abuse and Mental Health Services Administration Results from the 2001 National Household Survey on Brug Abuse Vol I. Summary of National Findings. Rockville, MB, Substance Abuse and Mental Health Services Administration, 2002b... 

Health sector development is a vital government obligation. In a national health system, proper use of well known and newer essential medicines for priority health problems depends on certain minimal level of medical and pharmaceutical services. This includes inexpensive diagnostic test to confirm diagnosis, and well-informed trained clinicians, pharmacists, nurses and other health staff to help patients, especially those with chronic illnesses, to adhere to their treatments. An overall capacity strengthening of the health and supply systems is a pre-requisite to respond adequately to the increased medical and pharmaceutical needs of populations. 

U.S. Department of Health and Human Services. Substance Abuse and Mental Health Services Administration. National Clearinghouse for Alcohol and Dmg Information. Heroin Treatment Admissions Increase 1993-1999. Washington, DC U.S. Dept, of Health and Human Services, January 2002. 

Inhalant abuse is a financial drain on society as well. Indian Health Services estimates a cost of 1.6 million to treat a young adult with a history of inhalant abuse and all its associated physical, mental, legal, occupational, and social problems. The Office of National Drug Control Policy (ONDCP) estimates that illegal drugs cost the U.S. economy 160 billion in the year 2000, an annual increase of 5.8% between 1998 and 2000. That estimate includes 14.8 billion in healthcare costs and 110.4 billion in lost productivity from drug-related illness, incarceration, and death. 

The current increase in the need for public health services comes at a time when the national public health infrastructure has been weakened by years of financial neglect. While the public health workforce has always provided for community disasters, the level of preparedness called for by the terrorist attacks on 9/11 necessitates training on a new and different level. The times in which we now live make it imperative that public health nursing keep pace with the demand for skills in the disaster and emergency response arenas. 

The role of the national and state governments in the health care system is limited to those entitlement programs that have been legislated into federal or state law or where there is a federal and state partnership. Federal involvement in the provision of health care services began with the U.S. Public Health Service (PHS), an agency of the U.S. government. The PHS was established in 1798 to provide essential health care services to merchant marine personnel and members of the U.S. armed forces. Subsequent federal involvement in the provision of and the payment for health care has incrementally increased to include care for individuals with special entitlements. The latter include veterans of the armed forces, the elderly, indigent people. Native... 

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