One-fifth of people ages 16 to 64 with a disability live below poverty as compared with 7% of those without a disability arrhythmia when sleeping cheap telmisartan 40mg without a prescription. Unemployment Since June 2007 heart attack high 3000 miles from the south telmisartan 80mg for sale, the Massachusetts monthly unemployment rates have been below the national unemployment rates. Before then, unemployment rates rose above the national rates during the recession in the early 1990s. Even though the state rate is lower than the national rate, it has risen over 28% per year since January 2008 (4. Since then, employment in those sectors has dropped, and that share of the workforce is now employed in professional and business, and health and social services. Today, about 40% of the civilian workforce ages 16 and over are employed in the managerial and professional occupations. The median earnings range for this group ranges from a low of $41,000 for community and social workers to a high of $81,500 for lawyers (Figure 1. These achievements are offset by the fact that 12% of the population has not graduated from high school. The percentage of Whites who do not have a high school diploma or equivalent is 10%, while the percentage of Hispanics is 35%. Those with an advanced degree have a median income that is almost three times that of those with less than a high school education (Figure 1. Conclusion the social and economic status of Massachusetts contributes to the health of the state. Its high education and income support healthy habits and good health outcomes among its citizens. The factors that often separate the prosperous and the poor are race and ethnicity, disability, age, gender, and immigration status. Efforts to evaluate and improve the state of health in Massachusetts must proceed from knowledge of the people and the conditions of their lives. As cities across the Commonwealth become majority-minority, disparities in educational achievement and labor market outcomes, as well as health disparities need to be addressed. While there are important distinctions within each race-ethnic category (among Latinos, Cubans fare better than Dominicans; among Asians, Koreans fare better than Cambodians; among Blacks, West Indians fare better than native-born African Americans), poorer outcomes for minorities require a retooling of antidiscrimination policy to reduce disparities in labor and housing markets as well as education programs aimed at reducing dropout rates and improving education achievement. However, the high cost of housing has made Massachusetts, and especially the Boston metropolitan area, increasingly unaffordable, driving talent to other high-tech metropolitan areas where housing costs are lower. The creation of more affordable housing depends on reform of local zoning laws and the continued implementation of state housing programs. If current Baby Boomers follow the path of previous generations of retirees, many will prefer to "age in place," in their current homes or elsewhere within their current communities. This will present challenges in many suburbs as local governments attempt to accommodate the 28 Health of Massachusetts housing and transportation needs of a population that will, of necessity, rely on other means than private automobiles. This too implies a rethinking of current zoning restrictions and a focus on increasing density to increase choice and mobility for this population. Policies created when Massachusetts was a faster-growing and less diverse place are obsolete. State and local governments will need to change their approach in a number of policy arenas, including education, antidiscrimination, housing, zoning, and transportation. The population for 2010 was projected by the Population Division in the State Interim Population Projections by Age and Sex: 2004 - 2030. Those born at sea or born in Oceania = < 1%, and they were excluded from this figure. In this figure, race and Hispanic ethnicity are not mutually exclusive, except for White Non-Hispanic. Demographics and Socio-Economics 31 32 Health of Massachusetts C H A P T E R 2 Community Assets C ommunity assets are resources that provide a healthier environment for Massachusetts residents and can have a great impact on the health and quality of community life. Community assets can range from physicians per capita to access to public recreation programs. Communities also vary widely when it comes to the disproportionate burden of disease, including diabetes, heart disease, asthma and other illnesses.
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Providers should take the following issues into account for both individuals and family blood pressure chart for 70+ year olds purchase telmisartan 80mg without prescription. When health literacy is low arteria transversa colli buy 20 mg telmisartan amex, simple verbal explanations may be more effective than written information. The direct care provider is responsible for interpreting and responding to behaviors. For example: · Apersonrepeatedlyrefusingacertainfoodor beverage may mean he or she does not like it. Controlling for pain and/or minimizing physical movements that cause pain can address this behavior. Proper care and use of hearing aids or other recommended assistive listening technology is important. Giving the person a view of the tub, starting the bath water before undressing, and keeping the bathroom warm can promote participation in undressing. Families need to know the symptoms of dementia and understand the progression of the disease. Providers must coordinate their work with families and others, including a private care manager the family or insurer hires. It can also include assigning a primary nurse or social worker to the person with dementia, and keeping regular contact through home visits, phone calls, or (if available and appropriate) email, text messages or other electronic technologies. They provide a variety of support services and may be trained by the home care team to deliver skilled services such as changing a sterile wound dressing or performing diabetes care. In addition, community-based services providing home-delivered meals, transportation or home modification often play a role. This patchwork of support services requires coordination and communication to be successful. Providers should take steps necessary to comply with state and federal law concerning privacy matters. Early on, people may have a hard time concentrating and experience irritability, anxiety or depression. Later in the disease other symptoms may occur, including: sleep disturbances, outbursts, emotional distress, paranoia, delusions (belief in something not real) or hallucinations (seeing, hearing, or feeling things that are not there). B e h av I o r a l sy m P t o m s - c au s e s and care · Apersonshowingbehavioralsymptomsneeds a thorough medical evaluation especially when symptoms come on suddenly. If an examination is not performed and symptoms are treated with drugs, the medication could not only mask the symptom but also create a much more dangerous situation. The use of psychotropic medication in this case would mask behaviors and leave the underlying cause untreated. Direct care providers need to communicate these symptoms to supervisors or other members of the home care team. A checklist, like the one below, can help identify behavioral symptoms: · Behavioralsymptomscanalsohavenon-medical causes. Assessment should also address personal comfort, pain, hunger, thirst, constipation, full bladder/bowel, and fatigue. Creating a comfortable environment can involve adjusting room temperature, providing supportive seating, eliminating glare, reducing noise levels and offering enjoyable activities. Providers should help families understand the importance of a comfortable home environment. If no trigger can be identified, distracting the person with dementia by changing the task, the environment, or the topic of conversation may be helpful. Treating any medical causes, and changing care or the environment to solve the problem. Effective treatment of one core symptom may sometimes help to relieve other symptoms. Sometimes medications can increase the frequency or severity of the symptom being treated. When considering use of medications, · Familycaregiversanddirectcareprovidersneed training in behavior management for persons with dementia.
This makes the significance of impacts to the timber industry less significant in terms of the impact to the overall economy blood pressure 400 cheap telmisartan 20 mg on-line. However blood pressure chart while pregnant buy 80mg telmisartan otc, it places greater significance, or sensitivity, on the impacts to the timber industry when considering the industry in isolation, as its own beneficiary. Percent of Total Private Employment in Industries that Include Travel & Tourism 25. Accommodation & Food Services Passenger Transportation Arts, Entertainment, & Recreation Retail Trade Figure 81. Percent of employment represented by industries that support travel and tourism compared to timber in counties within the analysis area Source: Headwaters Economics Economic Profile System, 2015. Poverty In the 2007-2011 period, Lake County had the highest estimated percentage of individuals living below poverty (23. In this same period, Sanders County had the highest estimated percentage of families living below poverty (16. Poverty level by age and family type in Montana and by county, 20111 Family Type People Families Individuals below poverty (% of total) Families below poverty (percent of total) Montana 958,682 256,806 139,904 (14. The data in this table are calculated by the American Community Survey using annual surveys conducted during 2007-2011, and they are representative of average characteristics during this period. In summary, the affected economic environment in the analysis area is mixed across counties. The counties that remain most sensitive to Forest Service planning are those with a higher percentage of private employment in industries that benefit directly from adjacent National Forest lands. Furthermore, counties with higher poverty rates, higher unemployment, lower income per capita, and higher non-labor personal income will remain more vulnerable to impacts to employment. For ease of analysis, quality of life is divided into three main categories: well-being; health and safety; and traditional, cultural, and spiritual practices. Well-being General indicators of the well-being of populations are educational attainment, income, and jobs. Income and jobs were addressed in the previous section; this section focuses on education. Those with higher levels of educational attainment are also considered less vulnerable to economic and environment shocks (such as the Great Recession and climate change) (Romero Lankao & Qin, 2011). At the county level, studies show that areas with a more highly educated workforce grow faster, have higher incomes, and suffer less during economic downturns than other areas. Those with higher levels of educational attainment also tend to be more civically engaged, with higher rates of voting and volunteering and lower rates of criminal behavior (Dee, 2004). In the four-county analysis area, for the years 2007-2011, educational attainment levels are above the state and national averages in terms of high school graduates (see table 175). There are also significant differences in educational attainment among the counties. Flathead and Lake Counties track closely to state and national averages, but Sanders and Lincoln Counties trail behind. Educational attainment as percent of total population age 25 and over, in Montana, by county in the analysis area, and in the United States Montana (%) 8. Well-being summary Overall, residents of the four-county analysis area enjoy a relatively high level of well-being. The percentage with a high school degree and an associate degree is higher than that of the nation as a whole, which is a key social indicator of overall well-being. Income and jobs are also important indicators of well-being and are summarized in the Economy subsection above. Health and safety General indicators of the level of health and safety of communities include access to exercise opportunities, air quality, water quality, income inequality, violent crime, and life expectancy. The health and safety conditions of the study area are relevant to forest planning as certain land management decisions may improve or worsen county health conditions. Therefore, it is important to consider the current health levels and conditions in the study area. Indicators included in the County Health Rankings and Roadmaps (a database of community health indicators provided by the University of Wisconsin) most relevant to land managers include access to exercise opportunities, water quality, and air quality. Income inequality and violent crime rates are also pertinent as resource extraction projects may lead to the creation of "boom towns," which have been shown to increase income inequality, temporarily disrupt communal ties, and increase fear of violent crime in the short term (Smith, Krannich, & Hunter, 2001). Indicators of health and safety levels in the analysis area related to land management Health and Safety Indicators Access to exercise opportunities1 Air pollution-particulate Drinking water Violent crime5 Income inequality4 matter2 Montana 72% 10.
Despite this heart attack flac torrent generic 40 mg telmisartan overnight delivery, attacks against civilians hypertension va compensation generic telmisartan 40mg on-line, including aid workers, are sadly still common occurrences. In Iraq, Oxfam was forced to close its office in 2004 due to the threat to its staff, although it continues to support Iraqi partners and in Afghanistan, Somalia, Darfur and elsewhere, there has been a rising trend of attacks on aid workers since 2006. Though the motives for individual attacks may be complex and uncertain, an increasing proportion of such attacks have been politically motivated. The growing influence of international humanitarian law was exemplified by the creation in 2002 of the International Criminal Court, which has 328 5 the international sYsteM global jurisdiction over genocide, crimes against humanity, and war crimes. Far more people, however, now flee violence but, willingly or unwillingly, remain within their own countries, without the same rights under international law. If they manage to reach a territory and make their asylum claim, they frequently find a culture of hostility and disbelief, and often face destitution, detention, deportation, and denial of due legal process. International mechanisms and institutions are needed to ensure that costs are shared equitably and that all parties are treated fairly. In November 2001 around Kisangani, the scene of intense fighting in the Democratic Republic of the Congo that involved many civilian deaths, Amnesty International found ammunition cartridges for North Korean, Chinese, and Russian heavy machine-guns, Russian revolvers, South African assault rifles, Chinese anti-aircraft weapons, and Russian, Bulgarian, and Slovak automatic grenade launchers. Many weapons are now produced by global supply chains spread across a number of different countries, similar to those found in the electronics industry. This enables companies to circumvent national controls on arms exports to human rights violators, an exercise in which governments North and South are colluding. In the past decade, however, the big four have been joined by China, India, Israel, South Korea, and South Africa. Based on the principles of international human rights and humanitarian law, such a treaty would create minimum global standards for arms transfers, preventing those 330 5 the international sYsteM likely to be used to violate human rights or hinder development. The success of similar moves on landmines (see How change happens: Landmines, an arms control success story) shows what can be achieved through co-ordinated international action. It may then take another 20 years before such a treaty is enforced as rigorously as it must be, but it will be essential for the international system for peace and security that such a Treaty comes into force and is allowed to function effectively. The political agendas in many of the most powerful countries shifted away from addressing causes towards policing consequences, and the West slipped back into a Cold War-style paradigm of protracted war. In retrospect, the 1990s look like a brief interlude in a bleak panorama dominated by an overwhelming focus on military security. However, it has relaxed controls on arming human rights abusers in countries such as Georgia and Pakistan, has increased restrictive measures in developed countries against asylum seekers and refugees, and has exacerbated xenophobic reactions to immigration. Relief agencies also find their ability to provide assistance without interference from combatants in conflicts curtailed in many countries, along with the freedom of civil society organisations to operate. Fighting terrorism certainly requires effective police and related security measures but after 2001, terrorism became a justification for seeking military solutions to problems that are more than military in nature, and poor people are paying a terrible price. Conflicts, as Part 4 showed, have local roots that require largely local solutions aimed at achieving peace and strengthening the combination of active citizens and effective, accountable states that holds the key to development. The international system can provide aid and diplomacy to support local efforts at conflict prevention and to relieve the terrible human toll when conflicts do break out. It can improve its aid to fragile and conflict-affected states and make violence and fragility central to its post-2015 development agenda. In exceptional circumstances, when governments are unable or unwilling to protect their own citizens, the international community should be ready to step in militarily. However, powerful countries must also address their own roles as drivers of conflict, whether through the arms they sell or as financiers of war through the purchase of natural resources. Just as risk and vulnerability at an individual or community level often require a level of social protection and safety nets to prevent shocks turning into long-term disaster, so at a global level countries need support, if natural disaster or conflict is not to overwhelm their ability to guarantee rights and dignity to their citizens. In turn, powerful governments need to show the same vision at a global level, as the founders of welfare states have done in the national arena, recognising that both morality and long-term self-interest require not only leadership, but a readiness to set aside short-term advantage and to put their own house in order on issues such as aid and the arms trade. Landmines were killing or injuring 26,000 people every year, and were stockpiled by some 125 countries. Now, thanks to an international treaty banning their use, that number has fallen to between 15,000 and 20,000 people a year. In 2005, only three governments those of Myanmar, Nepal, and Russia acknowledged using landmines (rebel groups used them in a further ten countries). The movement provided essential expertise to the diplomatic process and played a major role in the actual drafting of the treaty. Campaigners helped to draft the language of the final declaration and the action plan.
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