Agents and Representatives in Budgeting Process Research Proposal

Agents and Representatives in Budgeting Process - Research Proposal Example The role of agents in budgeting is of great significance and, hence, should not be overlooked. During the preparations of the annual budgets and reports from all the state organs, profit, and non-profit enterprises, all the stakeholders are represented via agents. The representing agents should be individuals with deep understanding of finance and knowledgeable in accounting. It is the participation of all the agents representing the relevant institutions in the budgetary process that is commonly referred to as departmental agency budgeting (Goodman and Clynch, 2004). This process entails four major stages, namely: i. Comprehensive Fiscal Policy Formulation Under this umbrella, the overarching institutional objectives are formulated and determined. It is these policies that regulates the decision making process regarding aggregate expenditure and revenue of the firm. ii. Preparation and Enactment of the Budget It is in this stage that the government decides on proportions of financia l allocation to be advanced to each agent, and also the government outlines the purpose for which the funds are allocated to a given agent. The guiding principles relating to these are set out clearly by the legislations enacted by the state. iii. Budgetary Execution This is the actual stage in budgeting. It involves carrying out the stipulated expenditure as developed in the budget plan. It is in this stage that contractual agreements are signed between the budgetary committee and the contractors (Goodman and Clynch, 2004). iv. Accounting, Auditing, and Reporting This being the final stage in budgeting, it is the post-ante process of preparing the accounting records regarding revenues and expenditures executed by the organization within a given fiscal period. These records must have been audited by both internal and hired external experts/auditors to ensure that they meet the international accounting and auditing standards. The final reports (audited reports) are then presented to the financers, government agencies, ministers, the public and the parliament. Objectives of Budgeting The following are the key objectives of budgeting: Sound Macro-Fiscal Result: This forms the backbone to aggregate fiscal policy objective in budgeting. To ensure fiscal sustainability, sound fiscal policies must be put in place to regulate financial operations and to ensure that organization short-term debts are paid when they fall due. This policy also acts as macro-stabilizer to the economy by regulating taxation policies during boom and recession. Appropriate Expenditure Prioritization: This policy advocates for effective allocation of resources to those projects that are deemed socially profitable. The corollary under this objective is to avoid misallocation of resources especially to least priority sectors of the economy, but instead to maximize on the social gains. Service Efficiency and Effectiveness: This implies that the state services delivery is made more efficient and e ffective in a manner that is socially justifiable and acceptable by all the stakeholders. 1. Budget Overview Taking an example of HIV/AIDS funding program, during the financial allocation process, all the departments involved must have their representative on board.

Can Terrorism be defeated by Military Means Only Essay

Can Terrorism be defeated by Military Means Only - Essay Example Can Terrorism be defeated by Military Means Only? A few examples of better ideas are the promises of peaceful change, social reforms and economic equity. Terrorism is a form of â€Å"asymmetrical warfare† in military parlance. This terminology defines it as a type of warfare in which one of the combatants (the weaker) chooses when and where to engage and fight the other side (the stronger enemy). The term asymmetry derives from the unequal status in terms of strength of the combatants in which a lightly-equipped force attacks the much-stronger enemy by using unorthodox means of hitting its enemy through weak points. By necessity, terrorists use ideas to gain access into people's minds and hearts to win them over to their cause. Terrorism is the dominant form of conflict in most of today’s hot spots. Anti-terrorism experts are agreed on its layman’s definition which is an act or a series of acts designed to sow terror or extreme fear. Police investigative techniques and military solutions are good only for the sh ort term but not really effective for the long haul. Discussion The aim of terrorists is intimidate and threaten people so they will act in a certain manner that is favourable or desired by the terrorists. This is but a simple form of coercion backed by threats of violence. Just as the saying that history is written by victors of a war, terrorism can be viewed from different perspectives, depending on who is using terror to achieve its aims. Individuals, groups and even governments use terror to help them achieve their objectives. Terrorism does not make any distinctions on the persons using terror but focuses on the means of terror. It means marginal groups can be labelled as terrorists as well as existing governments which employ the same techniques and methods. Agents who killed British soldiers in Palestine before Israel was given its independence were terrorists by the above definition and so were the Spanish secret agents under a previous administration during 1982 to 1986. Th e Guardia Civil (Spanish police) had formed their own terrorist units called as the Grupo Antiterrorista de Liberacion or GAL (www.onwar.com, n.d., p. 1) to counter threats posed by the growing ETA movement (Euskadi Ta Askatasuna) of the Basque region which initially had targeted members of the police and military. As can be gleaned from this initial discussion, terrorism can be viewed from different perspectives and as such could also be justified depending on who is using terrorism as a tool. In other words, terrorism is not a sole domain of disaffected individuals and marginal groups but also of duly-elected governments which find it convenient to use terrorism as state policy. Most terrorists today belong to organisations which are basically stateless. This state of being stateless is one other characteristic of asymmetrical warfare and is what makes the terror groups quite difficult to hunt down and defeat. Their structure is not hierarchical but rather more of a network which has redundant functions performed by several terror cells. In aftermath of Osama bin Laden’s reported death, many ordinary people expected terrorism threats to vanish away but anti-terrorism experts believe otherwise because the motivation is still there within the organisation of al-Qaida. The goals and the willingness to use terror have not changed a bit and many affiliated terror cells can still strike any time (Clarke, 2011, p. 1). In the thinking of most military

Policy Making Essay Example | Topics and Well Written Essays - 1250 words

Policy Making - Essay Example The contacts can be found in a government directory. The next step is initiating contact. This involves calling the offices or traveling to the offices personally. If an appointment is granted, the plan moves to the next part which involves correspondence on material. This is the part where any question that will be posed to the policy makers during the visit get availed to allow ample time for preparation. In addition, the policy makers will get a copy of the policy recommendation report to allow them to prepare for the discussion during the visit. After providing the material in focus, the next stage will involve setting up a date for the visit and the itinerary. The itinerary is generally focused on arrival at the policy makers’ offices and a schedule of the debates that will take place. The itinerary will be approved by both sides (we, the visitors and the policy makers). The visit will last for not more than two hours (Bensley & Brookins-Fisher, 2008). Overview of Recomme ndations The key strategies of the recommendations are proper patient-to-nurse ratio staffing, proper shift managements, and proper overtime management. The importance of these aspects of nursing is that they are the backbone of proper nursing environment. On proper nurse-to-patient ratio, the problem was that nurses in many hospitals were overwhelmed by the work they had to do. In some cases, one nurse had to tend to over sixty patients. This is a dangerous situation because nurses who are overwhelmed by their work get fatigued and, as a result, produce poor quality results (Kenner & Finkelman, 2012). On proper shift management, the problem identified was that nurses had to do very long shifts and in most cases worked on the same working quadrant for a long time. The long shifts made the nurses fatigued and demoralized them. The notion of working in the same quadrant over a long period of time made their work seem repetitive. Repetitive work makes the nurses numb to developments in the workplace. These developments are such as patient condition deterioration or any routine procedures that may need to be changed. My recommendation at this point is that the nurses should work shifts of less than eight hours and that the hospitals should do frequent rotation of the nurses in the wards (Kenner & Finkelman, 2012). On overtime management, the problem identified was that nurses did much overtime work. Daytime nurses tended to stretch their shifts into the night and vice versa. Other nurses took weekend jobs. The problem with overtime work is that it exhausts the nurses and confuses the doctors who will have already changed shifts. My recommendation is that nurses should be allowed as little overtime work as possible due to the nature of their work. Their work is sensitive and demands a lot of keenness (Kenner & Finkelman, 2012). Analysis of Empirical Evidence Empirical evidence showed that nurses who worked for long shifts had alarmingly poor results with many nursi ng related conditions attributed to them. Generally, nurses who worked long shifts complained of loss of concentration in work and stress. Doctors who worked with nurses, who worked long shifts, complained of laxity among those nurses and reduction in the quality of the nurses’ work. The case was worse among nurses who were registered and their unregistered assistants. In such cases, there was a breakdown in communication. Registered nurses who

Can Terrorism be defeated by Military Means Only Essay

Can Terrorism be defeated by Military Means Only - Essay Example Can Terrorism be defeated by Military Means Only? A few examples of better ideas are the promises of peaceful change, social reforms and economic equity. Terrorism is a form of â€Å"asymmetrical warfare† in military parlance. This terminology defines it as a type of warfare in which one of the combatants (the weaker) chooses when and where to engage and fight the other side (the stronger enemy). The term asymmetry derives from the unequal status in terms of strength of the combatants in which a lightly-equipped force attacks the much-stronger enemy by using unorthodox means of hitting its enemy through weak points. By necessity, terrorists use ideas to gain access into people's minds and hearts to win them over to their cause. Terrorism is the dominant form of conflict in most of today’s hot spots. Anti-terrorism experts are agreed on its layman’s definition which is an act or a series of acts designed to sow terror or extreme fear. Police investigative techniques and military solutions are good only for the sh ort term but not really effective for the long haul. Discussion The aim of terrorists is intimidate and threaten people so they will act in a certain manner that is favourable or desired by the terrorists. This is but a simple form of coercion backed by threats of violence. Just as the saying that history is written by victors of a war, terrorism can be viewed from different perspectives, depending on who is using terror to achieve its aims. Individuals, groups and even governments use terror to help them achieve their objectives. Terrorism does not make any distinctions on the persons using terror but focuses on the means of terror. It means marginal groups can be labelled as terrorists as well as existing governments which employ the same techniques and methods. Agents who killed British soldiers in Palestine before Israel was given its independence were terrorists by the above definition and so were the Spanish secret agents under a previous administration during 1982 to 1986. Th e Guardia Civil (Spanish police) had formed their own terrorist units called as the Grupo Antiterrorista de Liberacion or GAL (www.onwar.com, n.d., p. 1) to counter threats posed by the growing ETA movement (Euskadi Ta Askatasuna) of the Basque region which initially had targeted members of the police and military. As can be gleaned from this initial discussion, terrorism can be viewed from different perspectives and as such could also be justified depending on who is using terrorism as a tool. In other words, terrorism is not a sole domain of disaffected individuals and marginal groups but also of duly-elected governments which find it convenient to use terrorism as state policy. Most terrorists today belong to organisations which are basically stateless. This state of being stateless is one other characteristic of asymmetrical warfare and is what makes the terror groups quite difficult to hunt down and defeat. Their structure is not hierarchical but rather more of a network which has redundant functions performed by several terror cells. In aftermath of Osama bin Laden’s reported death, many ordinary people expected terrorism threats to vanish away but anti-terrorism experts believe otherwise because the motivation is still there within the organisation of al-Qaida. The goals and the willingness to use terror have not changed a bit and many affiliated terror cells can still strike any time (Clarke, 2011, p. 1). In the thinking of most military

Position Essay Example | Topics and Well Written Essays - 1000 words

Position - Essay Example Irrespective of the arguments that have been brought, it can be substantively argued that technology has enhanced the quality of life by making life easier and facilitating people in engaging with their daily activities efficiently and effectively. Technology and lifestyle are two inseparable aspects. People keep on changing their lifestyles based on the technologies that are being developed. Technologies have brought forth heightened levels of convenience and accessibility across all the dealings that people have on their daily basis (Cooper 1). On a normal day, a person wakes up to interact with technologies right from their bed, kitchen, road, to the workplace. A bundle of technology such as a smartphone has become a major accompaniment wherever and whenever; As a result of internet connectivity, an individual is able to access any information from any place. This has created a lifestyle where people are able to operate even from their homes. The implications are that people tend to become more independent and personal contacts become minimal. Though the lifestyle has constantly changed, the level of productivity has exponentially improved as a result of the convenience and ease of operationalization created by the use of t echnologies (Yu 217). The influence of technology is mainly for the general well-being of people. Many problems that confront people have found solutions in modern technologies. Technological products such as computers have ensured that life becomes easy, better, and quick. Communication from wherever part of the world has been transformed. In addition, transportation has been made easy and fast. A global view reveals that almost every facet of the human life has been influenced by technology mainly positively. As a result of these technologies, people’s social lives have been transformed significantly. On the positive note, it is possible to interlink

Race and Ethnicity Essay Example for Free

Race and Ethnicity Essay This course focuses on the issues, challenges, and opportunities presented by U. S. population diversity. Workplace issues related to employee diversity in terms of gender, race or ethnicity, socioeconomic class, and cultural background are emphasized. Policies Faculty and students will be held responsible for understanding and adhering to all policies contained within the following two documents: †¢ University policies: You must be logged into the student website to view this document. †¢ Instructor policies: This document is posted in the Course Materials forum. University policies are subject to change. Be sure to read the policies at the beginning of each class. Policies may be slightly different depending on the modality in which you attend class. If you have recently changed modalities, read the policies governing your current class modality. Course Materials Harvey, C. P. , Allard, M. J. (2009). Understanding and managing diversity (4th ed. ). Upper Saddle River, NJ: Pearson. Schaefer, R. T. (2011). Racial and ethnic groups (12th ed. ). Upper Saddle River, NJ: Pearson. All electronic materials are available on the student website. |Week One: Workplace Diversity | | |Details |Due |Points | |Objectives |Recognize the dimensions of diversity. |6/10/13 | | | |Differentiate the concept of inclusion from the concept of diversity. | | | | |Describe diversity and inclusion in the workplace. | | | |Reading |Read Ch. 1 of Racial and Ethnic Groups. | | | |Reading |Read Ch. 17 of Racial and Ethnic Groups. | | | |Reading |Read Introduction to Section I and Section I of Understanding and Managing Diversity. | | | |Participation |Participate in class discussion. |6/10/13 |2 | |Discussion Questions |Respond to weekly discussion questions. |6/10/13 |2 | |Learning Team |Create the Learning Team Charter. | | | |Instructions | | | | |Learning Team Charter | | | | |Learning Team |Review the Week One objectives and discuss insights and questions you may have. | | | |Instructions | | | | |Weekly Team Review | | | | |Individual |Apply critical-thinking skills to answer the following questions based on this week’s |6/10/13 |5 | |Thinking About Diversity|readings. The response to each question must contain 150 to 300 words. | | | |and Inclusion | | | | | |What are the dimensions of cultural diversity? Identify and briefly explain the dimensions by | | | | |referencing both textbooks. | | | | |With what ethnic, cultural, or other groups do you identify? Describe what members of your | | | | |social circle have in common. | | | | |What is the difference between diversity and inclusion? | | | | |What is the importance of workplace diversity training? | | | | |What is your experience with workplace culture? Could there be, or could there have been, more| | | | |inclusion? | | | | | | | | | |Format your paper consistent with APA guidelines. | | | |Week Two: Prejudice, Stereotypes, Discrimination, and Privilege | | |Details |Due |Points | |Objectives | |6/17/13 | | | |Explain how the concept of culture is used to construct group identity. | | | | |Analyze the social concept of race. | | | | |Describe how behavioral and thinking patterns apply to diversity issues. | | | |Reading |Read Ch. 2 of Racial and Ethnic Groups. | | | |Reading |Read Ch. 3 of Racial and Ethnic Groups. | | | |Reading |Read Ch. 5 of Racial and Ethnic Groups. | | | |Reading |Read Introduction to Section II in Section II of Understanding and Managing Diversity. | | | |Reading |Read Are African Americans Still Experiencing Racism? | | | | |in Section II of Understanding and Managing Diversity. | | | |Reading |Read Inventing Hispanics in Section II of Understanding and Managing Diversity. | | | |Reading |Read To Be Asian in America in Section II of Understanding and Managing Diversity. | | | |Reading |Review Ch. 6 of Racial and Ethnic Groups. | | | |Reading |Review Ch. 7 of Racial and Ethnic Groups. | | | |Reading |Review Ch. 8 of Racial and Ethnic Groups. | | | |Reading |Review Ch. 9 of Racial and Ethnic Groups. | | | |Reading |Review Ch. 10 of Racial and Ethnic Groups. | | | |Reading |Review Ch. 11 of Racial and Ethnic Groups. | | | |Reading |Review Ch. 12 of Racial and Ethnic Groups. | | | |Reading |Review Ch. 13 of Racial and Ethnic Groups. | | | |Reading |Review Ch. 14 of Racial and Ethnic Groups. | | | |Reading |Read this week’s Electronic Reserve Readings. | | | |Participation |Participate in class discussion. |6/17/13 |2 | |Discussion Questions |Respond to weekly discussion questions. |6/17/13 |2 | |Learning Team |Submit the Learning Team Charter. | | | |Instructions | | | | |Learning Team Charter | | | | |Learning Team |Review the Week Two objectives and discuss insights and questions you may have. | | | |Instructions | | | | |Weekly Team Review | | | | |Learning Team |Begin working on the Equal Rights Proposition Outline assignment due in Week Three. | | | |Instructions | | | | |Equal Rights Proposition| | | | |Outline | | | | |Individual Multicultural|Resources: Culturegrams database and Racial and Ethnic Groups |6/17/13 |15.

‘Medicalization’ in Current Health Policy

‘Medicalization’ in Current Health Policy Changing Public Health Priorities From Medicalization to Improving Built Communities Laura Schultz, Brett Weed, Ashini Fernando, Carolyn Moore,  Andrea Andersen, David Garcia Medicalization has greatly increased the emphasis on the delivery of clinical services to individuals, often at the expense of population-based solutions. We examine this phenomenon and offer an alternative that promotes public health by improving social, environmental, and physical determinants of health[HS1]. ‘Medicalization’ in Current Health Policy ‘Medicalization’ is the tendency for the practice of medicine to view a greater proportion of human behavior through a clinical lens (Zola, 1986). Among the examples of medicalization is the direct-to-consumer solicitation of prescription drugs for an arguably ever-increasing repertoire of conditions and afflictions (Frosch, Krueger, Hornik, Cronbolm, Barg, 2007) and increasing access to medical care as is evident through the initiatives implemented by the ACA[HS2]. Ever increasing amounts of money are being invested in treatment of chronic diseases, while a comparatively much smaller proportion is invested in preventing the same conditions (HHS, 2003). The United States spends more than 17% of their GDP on healthcare[HS3]. This per capita health expenditure is more than twice the average of countries of the Organization of Economic Cooperation and Development (Balding, 2014[HS4]), yet these numbers have translated not into better health but instead, a worsening trend in chronic diseases. US citizens also have significantly lower life expectancy in comparison (Woolf Aron, 2013). Despite these considerable investments in health care delivery, the costs associated with treating the manifestations of poor health continue to rise unabated. Over the last five years in North Carolina alone, approximately USD 80 million of the federal budget for public health was appropriated for primary care for the underserved populations (Trust for America’s Health, 2014[HS5]). Public Health Spending In contrast, public health only receives approximately 3% of the government budget and is underfunded (Balding, 2014). Nationally, 95% of health spending is for the apportionment of clinical services, while only 5% is invested in population-based solutions (Lantz, Licthenstein, Pollack, 2007). In North Carolina this division is even more extreme, with less than 1% of health spending dedicated to public health operations (Table 1[HS6]). Table 1. North Carolina Public Health Appropriations as a Percentage of Public Health Care Spending (Trust for America’s Health, 2014; Chantrill, n.d.) It is worth[CDL7] noting that the leading cause of mortality in the US, cardiovascular disease, accounts for annual healthcare costs that exceed USD $312.6 billion (HHS n.d.), yet when diagnosed early, disease progression can be addressed with non-pharmacological interventions[HS8]. In North Carolina, a mere 0.81% (~ USD 15 million, 2013) of the federal budget for public health was appropriated for prevention measures of all chronic diseases (Trust for America’s Health, 2014). These funding trends appear to support medicalization of health instead of prevention through public health efforts. Rather than continue to invest in a stopgap strategy of mitigating the impact of illness, we propose to instead invest in the prevention of illness[HS9]. Addressing Social Determinants Population health investments within corporate environments have shown considerable financial success and value beyond return on investment (ROI). One corporate wellness program saw a ROI of close to 300%; another company saved an estimated $224 per employee in 2003 dollars from promoting health rather than treating a lack of it (HHS, 2003[HS10]). Applying this same per capita savings rate to North Carolina, shifting funding to prevention and health promotion could yield savings of $2.2 billion annually[3], more than offsetting the annual increases in health services expenditures. Value beyond ROI includes physical and mental health, quality of life, perceived health status and functional capacity. Workplace well-being also promotes other intangibles such as increased social cohesion (Pronk, 2014). There is an established correlation between positive social relationships and health. As Robert Putnam wrote in 2000 in Bowling Alone, â€Å"social capital† conveys the essential health promoting value of communities[HS11]. It is defined as â€Å"the social networks and interactions that inspire trust and reciprocity among citizens† (as cited in Leyden, 2003). Social isolation, independent of other lifestyle factors, is linked to premature death and decreased resistance to disease (Cohen, 2001). Beyond individual health, social capital is associated with political engagement, volunteerism, decreased crime rates and economic development (Leyden, 2003). Research has shown that when we design our communities to encourage social engagement there is a positive effect on the psychological and physical health of the residents (Leyden, 2003[HS12]). Since the advent of the automobile, the design of our communities has included limited transportation choices. Most individuals choose to travel by car because urban design has made most options for pedestrians unsafe (Vandergrift, 2004). The US, compared to other high income European countries with better health measures, have at least 25% more automobiles per 1000 people (Woolf Aron, 2013). European Countries also have policies which limit sprawl and prioritize â€Å"urban centralization†. Though difficult to quantify, these environmental factors are likely to contribute to the health disparities and disadvantages in the US (Woolf Aron, 2013). Political and social conditions and constructs, racism for example, also results in poor urban design that compound health disparities including limited access to businesses and markets, exposure to environmental toxins, and lack of opportunities for social participation. Specifically, infrastructure investment decisions, such as libraries, parks, public safety and maintenance are likely to be allocated to geographic areas populated by citizens with greater socioeconomic status and political power, which further marginalize disadvantaged socioeconomic groups (Schulz Northridge, 2004). Alternatively, mixed use, pedestrian friendly communities are based on thoughtful design and include intact town centers, multiple income residences and well linked streets that are designed for people, not automobiles (Walkable Communities, n.d.). Prioritized determinants of health, which we expect to improve because of innovative planning include increased social engagement, improved economic status and increased physical activity (Walkable Communities, n.d.). As of 2012, approximately 50% of the US adult population has been shown to suffer from chronic diseases. However, adequate physical activity has been scientifically proven to prevent or improve these chronic disease conditions[HS13]. Yet, according to a 2011 statistic from the CDC, 76% of adults did not meet the recommendation for muscle-strengthening physical activity which is a known risk for heart disease (CDC, 2014). There are states where the built environment is viewed as worthy of significant investment to improve population health. Specifically, in Massachusetts there are two examples of lower than average socioeconomic status communities where health impact assessments indicate that built environmental improvements would improve social factors and likely decrease expenses in medical intervention. In Somerville, there is a community driven planned change to a bisecting interstate. This plan, made with consideration for social health determinants of the residents includes multi use bike and walking paths with increased access to all areas of the community[HS14]. Community-wide access will provide opportunities for social interaction, physical activity and increased choices for employment (MassDOT, 2013). A community with similar demographics, Fall River, has proposed common trails for recreation and pedestrian and bicycle travel that connect residents to businesses. This is predicted to improv e every health determinant the HIA evaluated (MAPC, 2013). Based on a review of state sponsored health impact assessments in other communities, there is a significant relationship between communities with walkable pathways and health (Rails to Trails Conservancy, 2013). We propose that thoughtful environmental structure enhancements such as multi-use walking and biking paths will connect neighborhoods and businesses. In turn, we believe these changes will positively affect social cohesion, economic viability and physical activity, which are all key determinants of health that can improve with innovative public policy implementation[HS15]. Conclusion and Recommendations Evidence from state sponsored health impact assessments in other communities, indicates that there is a positive correlation between communities with walkable pathways and health (Rails to Trails Conservancy, 2013). Environmental structure enhancements such as multi-use walking and biking paths that connect neighborhoods and businesses could positively influence population health in North Carolina. We believe these changes will positively affect social cohesion, economic viability and physical activity, which are all key determinants of health that can improve with innovative public policy implementation. In North Carolina there are 31 completed Rails to Trails programs (NC Rails-Trails, 2014). This national program improves the built environment by converting former railroad routes to pedestrian and bike friendly paths. However, only 2 of the 31 completed trails are located in counties with the poorest health scores (RWJF 2014; NC Rails to Trails, 2014). Eastern North Carolina, where 9 out of 10 of the most poorly rated counties for health outcomes are located, also have the fewest trail initiatives (NC Rails-Trails, 2014). This skewed distribution of environmental improvements further demonstrates the way in which populations within poor socioeconomic communities are financially neglected, and thus likely to continue to suffer from worse health outcomes. Using Massachusetts as an example, the state’s Department of Health and Human Services has initiated a program to identify communities with the lowest socioeconomic status and assist them to â€Å"build policies, systems and environments that promote wellness and healthy living† (MassDOT, 2013). In partnership with state and county planning officials, public health leaders, and state demographers, our plan is to target lower socioeconomic communities, initially focusing on a county with the poorest health indicators, to plan and build multi-use trails. We request priority funding allocated through the US Department of Transportation via the Moving Ahead for Progress in the 21st Century ACT (MAP-21), as well as private foundation grants that prioritize state population health improvements like the Annie E. Casey and Doris Duke foundations. Our plan for advocacy is to engage community members in the trail project as stakeholders. Specifically we will encourage our members to influence policy decisions through community informational meetings, including letter writing assistance intended to exert pressure on local politicians. We intend to host community or health center â€Å"coffees† with opportunities to meet county commissioners and planners. Media coverage in the lo cal newspaper is another part of our advocacy plan. Specifically, we will engage local media in an effort to â€Å"frame† the problem of poor environmental design and how it impacts health by profiling one citizen with health risks and limited transportation options who lives on a pedestrian unsafe street, visually depicting the social isolation inherent in this environment though a photo layout[HS16]. By engaging our most vulnerable North Carolina citizens to take part in improving their quality of life and ultimately their health and longevity, we will have the best chance at community environmental improvement as a long term effort. The time is now to refocus our priorities on health investment through prevention and promotion of public health efforts rather than treatment of diseases. References Blanding, M. (2012). Public Health and the U.S. Economy. Retrieved from http://www.hsph.harvard.edu/news/magazine/public-health-economy-election/. Chantrill, C. (n.d.). North Carolina Government Spending Chart. Retrieved from http://www.usgovernmentspending.com/spending_chart_2003_2019NCb_16s1li111mcn_13l14t Centers for Disease Control and Prevention (2014, October). Chronic Disease Prevention and Health Promotion. Retrieved from http://www.cdc.gov/chronicdisease/overview/index.htm. Cohen, S (2001). Social relationships and health: Berkman syme (1979). Advances in mind-body medicine. 17(1):5-7. Frosch, D. L., Krueger, P. M., Hornik, R. C., Cronbolm, P. F., Barg, F. K. (2007). Creating Demand for Prescription Drugs: A Content Analysis of Television Direct-to-Consumer Advertising. Annals of Family Medicine, 5(1), 6-13. Lantz, P. M., Licthenstein R. L., Pollack, H. A. (2007). Health policy approaches to population health: The Limits of medicalization. Health Affairs, 26(5), 1253-1257. Leyden, K. (2003). Social Capital and the Built Environment: The Importance of Walkable Neighborhoods. American Journal of Public Health, 93(9), 1546-1551. Massachusetts Department of Transportation. (2013). Health Impact Assessment of the Massachusetts Department of Transportation (MassDOT) McGrath Grounding Study. 2013. Retrieved from http://www.massdot.state.ma.us/groundingmcgrath/HealthImpactAssessment.aspx. Metropolitan Area Planning Council (MAPC) (2013). Health Impact Assessment: Quequechan River Rail Trail Phase 2. Retrieved from http://www.mapc.org/quequechan-river-rail-trail-hia. NC Rails-Trails (2014, September). Resources. Retrieved from http://www.ncrailtrails.org/web/resources. Pronk, N. P. (2014). Placing Workplace Wellness in Proper Context: Value Beyond Money. Preventing Chronic Disease 11, 1-4. http://dx.doi.org/10.5888/pcd11.140128 Putnam, R. (2000). Bowling Alone: The collapse and revival of American community. New York: Simon Schuster. Rails to Trails Conservancy. Health and Wellness Benefits. (n.d.). Retrieved from http://www.railstotrails.org/ourWork/trailBasics/benefits.html. Robert Wood Johnson Foundation (2014). County Health Rankings and Roadmaps, Building a Culture of Health County by County; 2014 Rankings; North Carolina. Retrieved from http://www.countyhealthrankings.org/sites/default/files/state/downloads/CHR2014_NC_v2.pdf Schulz, A., Northridge, M. E. (2004). Social determinants of health: Implications for Environmental Health Promotion. Health Education and Behavior, 31(4), 455-471. Trust for Americas Health (2014). Key Health Data about North Carolina. Retrieved from http://healthyamericans.org/states/?stateid=NC#section=3,year=2009,code=undefined US Census Bureau (2014, July 8). NC quick facts. Retrieved from http://quickfacts.census.gov/qfd/states/37000.html US Department of Health and Human Services (HHS) (2003, September). Prevention makes common â€Å"cents†. Retrieved from http://aspe.hhs.gov/health/prevention/. US Department of Health and Human Services (HHS) (n.d.). About Heart Disease Stroke. Retrieved from http://millionhearts.hhs.gov/abouthds/cost-consequences.html#cost. Vandergrift, D., Yoked, T. V. (2004). Obesity rates, income, and suburban sprawl: an analysis of US states. Health Place, 10, 221-229. Walkable Communities, Inc. (n.d.).Walkable Communities FAQ. Retrieved from http://walkable.org/faqs.html. Woolf, S. H., Aron, L. Y. (Eds.). (2013). U.S. Health in International Perspective: Shorter Lives, Poorer Health. Washington DC: National Academies Press. Zola, I. K. (1986). Medicine as an institution of social control. In P. Conrad R. Kern (Eds.), The sociology of health and illness. New York: St. Martins Press. [1] Rounded to nearest million [2] Rounded to nearest ten million; represents NC state and locality public health care spending [3] Based on 2013 NC Population Estimate of 9,848,060 (US Census Bureau 2014). [HS1]Nice introduction to your paper [HS2]Good examples [HS3]Is this from your Balding reference? This statement needs to be referenced. [HS4]This is listed as Blanding on your reference list. [HS5]Very nice section, your reader will have a good understanding of medicalization after reading this section [HS6]Great reference and statistics that support your premise [CDL7]Do not use this construct in this class, â€Å"it is†, â€Å"there are†, etc. [HS8]Such as implementing lifestyle changes with diet exercise. [HS9]Very good! [HS10]Impressive! [HS11]Very interesting, I will be reading this. [HS12]Great examples and points being made, excellent references. [HS13]You need a reference here [HS14]This entire section isn’t referenced. Unless this information is considered to be â€Å"common knowledge† e.g. it came from your own brain or was information you were aware of prior to writing this paper, it needs to have a citation. Please review when to cite from UNC library http://www2.lib.unc.edu/instruct/citations/index.html?section=why_we_cite [HS15]Great ideas [HS16]Great ideas and plan of action