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The History and Practice of College Health

The History and Practice of College Health

H. Spencer Turner
Janet L. Hurley
Copyright Date: 2002
Edition: 1
Pages: 480
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  • Book Info
    The History and Practice of College Health
    Book Description:

    This volume is the first definitive reference and textbook in the one-hundred-fifty year history of college health. Written for professionals and for those working in student services and higher education administration, it covers the history of college health, administrative matters including financing and accreditation, and clinical issues such as women's health, HIV/AIDS, and mental health. The book also focuses on prevention, including immunization and tuberculin testing. The contributors are well respected in the field and are actively working in the specific areas on which they write.

    eISBN: 978-0-8131-4998-1
    Subjects: Education, Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-iv)
  2. Table of Contents
    (pp. v-vi)
  3. Acknowledgments
    (pp. vii-viii)
  4. List of Contributors
    (pp. ix-xvi)
  5. Chapter 1 The History and Development of College Health
    (pp. 1-21)
    H. Spencer Turner and Janet L. Hurley

    “There shall be no scollar nor infaunt, of what country or shire so ev. he be of, beyng man child, be refused, except he have some horrible or contagious infirmyties wiche he, and shall alwaies be, remytted to the discretion of the Warden or deputie for the time beyng.”1,p. 1This regulation was promulgated in the fifteenth century by regents of Manchester College, London, by which students with “horrible and contagious infirmities” were excluded from enrollment. Fortunately, by the beginning of the nineteenth century a more enlightened approach had developed for dealing with issues related to “infirmities” of one sort...

  6. Chapter 2 College Health at the National Level
    (pp. 22-41)
    Doyle Randol, Sarah Feiss, Sharon Fisher, Richard P. Keeling and Marthea Blewitt

    The American College Health Association (ACHA), founded in 1920, is dedicated to serving the health needs of students at colleges and universities. It is the principal leadership organization for the field of college health and provides services, communications, and advocacy that help its members to advance the health of their campus communities.

    Today, ACHA’s membership has grown from the original 20 institutions of higher education to more than 900. These member institutions represent the diversity of the higher education community: two-and four-year, public and private, large and small. ACHA also serves more than 2,000 individual college health care professionals: administrators,...

  7. Chapter 3 Administration and Financing of College Health
    (pp. 42-78)
    Wayne H. Ericson, Dana M. Mills and Gerald R. Ledlow

    The practice of college health is essentially an unrecognized specialty in the broader health care system. The population being served is traditional college-aged students and a growing number of non-traditional students who, collectively, present significant challenges from both clinical care and marketing standpoints. Because of the ongoing developmental nature of this population, there are also challenges to effective preventive health care.

    Health care services are among the most complicated organizational structures in society. The college health service on most campuses is not only a microcosm of the health care and prevention activities existing in society and thus subject to the...

  8. Chapter 4 Quality Improvement and Accreditation Issues in College Health
    (pp. 79-103)
    Betty Anne Johnson and Betty Reppert

    The mission of every student health service (SHS) is to provide high-quality health care in a cost-effective manner. Quality health care can be defined in many different ways, however, and until recently, there was little agreement on how best to attain it. The Institute of Medicine defines quality of health care as “the degree to which health care services for individuals and populations increases the likelihood of desired health outcomes and are consistent with current professional knowledge.”¹ This definition reflects the growing consensus that the measurement of quality in health care should also include some assessment of outcomes of that...

  9. Chapter 5 Primary Care Issues In College Health
    (pp. 104-117)
    John M. Dorman and William A. Christmas

    As American colleges and universities proliferated in the nineteenth century, concerns developed on the part of college administrations that the health status of college students (to the extent that it interfered with the pursuit of their studies) was an issue deserving attention. The expectation was, in this pre-antibiotic era, that optimizing health through education about nutrition, exercise, and mental health would render the individual less susceptible to communicable and other diseases, thereby leading to a more vigorous and satisfying life (and by extension, to a more effective learning environment). Thus it is not surprising that the early college health services...

  10. Chapter Six Women’s Health Issues and Contraception in College and University Health Services
    (pp. 118-140)
    Thomas Dale and Pamela Woodrum

    Gynecology services provided by college and university health programs evolved throughout the last century, with their development being closely intertwined with societal trends. The medical and social responses to the gynecological problems of previous generations of college women may seem almost quaint, and certainly inadequate, to women of the twenty-first century. Fledgling gynecologic programs within college and university health services matured because of the requests, demands, and needs of college women. And, not surprisingly, these programs continue to be modified by community expectations and acceptance.

    Until the 1960s most college women received their gynecologic care from their physicians at home....

  11. Chapter Seven Nursing Issues in College Health
    (pp. 141-160)
    Karen M. Butler, Peggy Ingram Veeser and Jean Benthien

    Contemporary nursing, while the product of a rich evolution, has never deviated from its central core of caring for others. Beginning with Florence Nightingale in the 1800’s and continuing with today’s scholars and practitioners, nursing has had multiple definitions during the past 150 years. In 1860, Nightingale defined nursing as the noncurative practice in which the patient is put in the best condition possible for nature to act.¹ At midtwentieth century, Hildegarde Peplau described nursing as a significant therapeutic interpersonal process that functions in conjunction with other human processes to make health possible for individuals.² In 1966, Virginia Henderson stated...

  12. Chapter Eight Sexually Transmitted Diseases and College Health
    (pp. 161-179)
    H. Spencer Turner, Patricia R. Jennings and Alice C. Thornton

    The diagnosis and treatment of sexually transmitted diseases (STDs) have been inextricably linked with the practice of college health—if not since its beginning—at least for the past 80 years. Dr. William F. Snow, who had previously been a director of the student health service at Stanford University, as the first director of the American Social Hygiene Association (ASHA) was assigned the responsibility of combating venereal diseases in the military, at the outset of World War I in 1918. The distribution of the funds appropriated by Congress to carry out that responsibility is of particular relevance to college health....

  13. Chapter 9 HIV/AIDS in College Health and Higher Education
    (pp. 180-191)
    Richard P. Keeling

    The human immunodeficiency virus (HIV) is a recently discovered human T-lymphocytotropic infectious agent that causes a chronic, progressive acquired immunodeficiency state (HIV infection). HIV infection almost invariably becomes symptomatic because of the development of a variety of opportunistic infections and neoplasms typical of T-lymphocyte deficiency states (HIV disease). The most severe phase of HIV disease, characterized by striking reductions in helper T-lymphocyte counts (below 200/mm³), major, life-threatening opportunistic infections, and/or certain unusual cancers, is called the acquired immunodeficiency syndrome (AIDS). College health, and higher education more generally, have recognized and responded to the significant challenges HIV/AIDS creates for students (and...

  14. Chapter 10 Mental Health Issues in College Health
    (pp. 192-208)
    Leighton C. Whitaker

    Campus mental health and counseling programs began in the early to mid-twentieth century. The need for these programs was fostered by student personnel programming and was related to the emergence of the mental hygiene movement, the advent of psychiatry as a full-fledged medical specialty, and the growth of psychology as a profession.¹ Robert Arnstein, psychiatrist and longtime leader of Yale University’s student mental health program, has given an excellent account of the historical diversity of early developments in the field.²

    Typically, “mental health” services are part of university health services, while “counseling” or “psychological” services are free-standing units in student...

  15. Chapter 11 Substance Abuse Issues in College Health: Alcohol, Tobacco, and Other Drugs of Abuse
    (pp. 209-230)
    Betty Reppert and Betty Anne Johnson

    Heroin, cocaine, marijuana, and PCP have received much public attention in our society as drugs of abuse. However, the two substances that have the most potential for increasing morbidity or mortality of college students, in the short or long run, are alcohol and tobacco. This chapter provides an overview of substance abuse on college campuses, with a concentration on those two substances.

    Alcohol abuse is associated with significant morbidity and mortality throughout the United States. The American college student is no exception. Alcohol abuse puts students at increased risk for motor vehicle accidents, poor academic performance, violence, unwanted pregnancy and...

  16. Chapter 12 Unique Health Care Needs in Health Science Students
    (pp. 231-249)
    Wylie Hembree

    Health science students make up a unique, definable constituency of student health services. Their education and/or training occurs exclusively, or in part, in the health care setting. Even before the writings of Hippocrates, it was recognized that students in medicine were at risk of contracting the illnesses they were trying to cure. In addition, they were noted to be responsible for communicating disease to their patients.* Thus student health services have the dual responsibility of protecting both student and patient—a charge uniquely occasioned by the nature of the academic curriculum of health science students.

    Assuming the responsibility of certifying...

  17. Chapter 13 Health Care Issues for the International Student
    (pp. 250-262)
    Mary Alice Serafini, Pornthip Chalungsooth, Christopher A. Sanford and Elaine C. Jong

    The diversity of the student population in colleges and universities offers extraordinary opportunities and challenges to a student health service. International students represent a large group of diverse students encompassing special characteristics and exhibiting special needs. These students come to colleges and universities with a variety of backgrounds and experiences. The health provider’s constant challenge is to recognize the uniqueness of each student patient and to develop a knowledge base of cultural information, which will allow successful interventions, diagnoses, and treatments.

    During academic year 1999-2000, 465,002 international students studied in the United States.¹ Of this population, well over 50 percent...

  18. Chapter 14 Special Issues in Athletic Medicine
    (pp. 263-301)
    Mark Jenkins

    College health care practitioners encounter an extensive range of sports related medical problems in the student population. This is true regardless of whether the clinician serves in a designated capacity of “team physician” for the university’s athletic department or whether he/she sees students only when they seek care at the health center. Because students’ involvement in athletics encompasses not only many types of sports but also levels of participation, the health care professional must be prepared to recognize and manage the wide variety of problems generated by sporting interests.

    Thus, “athletic medicine” at the university level may be considered to...

  19. Chapter 15 Health Services for Students with Disabilities
    (pp. 302-310)
    Marlene Belew Huff and Joyce B. Meder

    In the 1995–96 academic year, as part of the National Postsecondary Student Aid Study (NPSAS), 6% of a nationally representative sample of 21,000 undergraduates indicated having a disability such as a hearing or speech disorder, a mobility impairment, or vision problems not correctable with glasses. Twenty-nine percent indicated a learning disability, 23% an orthopedic impediment, 16% non-correctable low vision, 6% decreased hearing or deafness, and 3% a speech impediment. Twenty-one percent reported “some other health-related” disability.¹ And, while some disabilities are obvious, like most of those just described, other disabilities are “hidden,” such as learning disorders and mental illness....

  20. Chapter 16 Health Promotion in Higher Education
    (pp. 311-327)
    Christine G. Zimmer

    Over the past two decades, institutions of higher education have been recognized as integral partners in the quest for achieving national health priorities. These priorities focus on the prevention of unnecessary disease, disability, and human suffering and on access to preventive health services for all.1,2Higher education will be held accountable for leading and shaping these health priorities for learning communities. This will require a fuller definition and understanding of the characteristics, risk perceptions and risk behaviors of students, faculty, and staff. It will also involve the assessment of community dynamics affecting health, learning, community connection, and citizenship. Institutions of...

  21. Chapter 17 Student Health Insurance
    (pp. 328-357)
    Stephen C. Caulfield

    Student health insurance has an important component role as it relates to the economics of student health programs, and to the shaping of the direction and content of student health services.

    Health insurance for students is strongly influenced by the larger context of employer-sponsored health insurance programs. In that context, the health insurance industry in the United States has undergone three significant changes in the past decade. The first is consolidation. In 1990, health insurance was provided by Travelers, Metropolitan, Prudential, Mass Mutual, Hancock, or a variety of state-based Blue Cross plans. Today, many of these insurers have been acquired...

  22. Chapter 18 Immunizations and Tuberculin Testing
    (pp. 358-378)
    Mark R. Gardner and H. Spencer Turner

    Among the most important public health accomplishments during the 20th century were the steps made toward the control of infectious diseases.¹ From a level in 1900 of about 800 deaths per 100,000 population per year caused by infectious disease, a rather precipitous decline began in this death rate,* which, even with the introduction of penicillin in about 1940, and the Salk polio vaccine in the early 1950s, continued at the same rate until a leveling-off point about 1960. This decline reflected a sharp drop in infant/child mortality and resulted in nearly a 30-year increase in life expectancy. In 1900, 30%...

  23. Chapter 19 Integrating Public Health and Clinical Preventive Medicine into College Health
    (pp. 379-403)
    Ted W. Grace

    The origins of college health are traceable to movements in the early 1800s that incorporated physical education and hygiene into the college curriculum, but it was an emphasis on the control of communicable diseases in the 1900s that first brought public health issues onto college campuses.¹ An increasing interest in intercollegiate athletics further strengthened the emphasis on physical activity, and athletic medicine began to gradually separate from student health services at many universities. The onset of World War I led to increased attention to the health status of the youth of the United States and to the creation of another...

  24. Chapter 20 Non-Student Medical Programs in Student Health Services
    (pp. 404-414)
    H. Spencer Turner and Janet L. Hurley

    From their beginnings, student health services directly or indirectly offered services for faculty and staff, thereby extending their parameters beyond student care. This extension was usually related to public health activities, which were often the impetus for the development of college health services in the first place. Obviously, when an epidemic required treatment and isolation of students, the effects of this treatment and isolation extended beyond the student body, and, in fact, helped protect faculty and staff. While this institutional public health role for student health services was traditionally unrecognized (or at least not acknowledged) by institutions of higher education,...

  25. Chapter 21 Physical Plant: Construction, Maintenance, and Safety
    (pp. 415-438)
    J. Robert Wirag and Robert Watson

    The purpose of this chapter is to orient the reader to the process involved in new construction or major renovation of a campus health care facility and to highlight the various aspects of building maintenance. Given the heterogeneity of college campuses, it will be necessary for the reader to “tailor to fit” the information contained in this chapter according to “at-home” realities.

    The first part of the chapter posits a new paradigm … call it the NASH facility (for New Age Student Health). As a new framework for thinking about the kind of facility one envisions working in and in...

  26. Index
    (pp. 439-461)