Public Health and Palliative Care

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Traditional public health roots

Traditionally public health has played great attention to maternity, birth, and childhood illness, all of which were important in society. The needs of disadvantaged communities, such as the homeless, economically deprived, disabled, elderly, and minority ethnic communities, also feature highly in public health reports. The prevention of disease, whether primary, secondary, or tertiary was the initial focus of much public health attention. When infectious disease was prevalent, public health

Changes in population

The challenges for public health change as the population changes and causes of morbidly and mortality shift. Over the past century in developed countries, longevity has improved, largely because of the defeat of many of the killers of the past. The causes of death have changed, altering the nature of death. More people are dying from serious chronic diseases rather than from acute illnesses. For example, in 1900 in many countries, including in Europe and North America, the leading causes of

More cost-effective solutions

The increased costs of health care generally, and in particular the high costs of high-tech care used often up until death, have intensified debate around care at the end of life. In the United Kingdom, 22% of bed days are occupied by people in their last year of life [44]. In the United States, 10% to 12% of total health care costs are spent on the end of life [45]. Although less than 5% of Medicare recipients die each year, the costs of services in the last year of life represents 25% of the

Summary

For a multitude of reasons, palliative care is an important health issue. It represents a significant burden of illness and cost to the community, suffers from inequities in access, and is set to be a major health concern for the future. What is surprising is the lack of public emphasis on palliative care, the gaps in implementing what is effective and in training professionals, and the vast deficits in research support to find effective solutions. What is needed now is a concerted effort by

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