While all human beings are afforded equal rights and opportunities, a person’s abilities and capacity change as they grow older. Older adults are therefore at times disadvantaged as a result of diminishing physical abilities or the stereotypical views that the general public holds concerning the old. As a result of this, older adults are sometimes categorized as being vulnerable. This paper shall argue that the categorization of older adults as vulnerable is right. To reinforce this assertion, the paper shall highlight some of the risks that make older adults vulnerable.
Why the Elderly are at risk
A major risk that the elderly face is that of abuse. Black (2008) states that abuse of the elderly is an escalating problem due to the huge dependency that the elderly have on caregivers. This dependency is a result of physical deterioration such as vision and hearing impairment, slowed mental response and decreased coordination that the elderly face (McGee, 2008). Most abuses against the elderly occur in the home setting and these abuses include neglect and exploitation of the elderly by the people who are supposed to be caring for them. The highest growing category of abuse is financial exploitation which is characterized by unscrupulous persons engaging in an illegal or improper use of the finances of the elderly.
Another risk that older adults face is discrimination in the workplace. McGregor and Gray (2006) note that persistent stereotypes are hugely responsible for this discrimination which arises from social prejudices against older people in general. A study by McGregor & Gray (2006) revealed that older workers were perceived to have problems with technology, rigid (resistant to change) and less willing to work for longer hours, therefore, reinforcing the claim that discrimination against older workers is mostly a result of stereotypical views held about them.
How to Eliminate the risk
With regard to the issue of discrimination in the workplace, the role of the government cannot be overstated. McGregor & Gray (2006) assert that employers if left to themselves, would be reluctant to enforce policies that protect the elderly from discrimination if they did not yield to additional profits. The welfare of the older adult workers would therefore be secondary to profitability. The government can step in and combat discrimination on the basis of age through the enactment of policies that outlaw this practice.
As has been noted, the most prevalent form of abuse against the elderly is financial exploitation. This abuse is especially adverse since it robs the elderly of their means of sustenance in old age. Black (2008) reveals that stricter laws crafted by states can help prevent elder abuse. For example, laws have been enacted in some states which require that financial institutes safeguard older adults from abuse. This protection is implemented by having the banks report all suspected incidents of financial abuse against the elderly bankers.
Conclusion
This paper set out to argue that older adults can be rightfully categorized as vulnerable. It has been demonstrated that as a result of their deteriorating physical conditions, the elderly are forced to rely on caregivers who may abuse them. In another case, the elderly may be ill-treated in the work setting due to stereotypical views. This paper has proposed measures of eliminating these risks to the elderly. The role of the government has been seen to be of great importance since the government can come up with policies that outlaw discrimination and/or protect against exploitation.
References
Black, J. A. (2008). “The Not-So-Golden Years: Power Of Attorney, Elder Abuse, and Why Our Laws are Failing a Vulnerable Population”. St. John’s Law Review, Vol. 82: 289.
McGregor, J. & Gray, L. (2006). “Stereotypes and Older Workers: The New Zealand Experience”. Social Policy Journal of New Zealand, Issue 32.
McGee H, M., et al. (2008). “Vulnerable older people in the community: Relationship between the Vulnerable Elders Survey and health service use”. J Am Geriatric Soc 2008; 56:8–15.
Ambulatory care provides an important contact between the healthcare facilities and the people benefiting from this program. This raises the importance or need for their careful planning both in terms of facilities and staff, among other issues. In the consideration of the program for the ambulatory health care center, issues such as efficiency, quality, and diversity of the services provided must be considered. Quality means that the services provided must not only march the requirements, but also be up to a certain standard or level. This is determined by the quality of staff such as the education level and the facility used. Efficiency would mean being able to serve as large number of patient as possible compared to those who seek the intervention. The program for running the facility must therefore take into consideration issues of the possible number of clients to be served. Ambulatory care centers also perform a crucial role as taking-in points for the patients who require medical attention; serve as points of contacts for the on-going, routine, and follow-up practices; serve as centers for referral operations for specialized services; and offer services such as emotional, psychological, social and psychiatric support.
The quality of the program to run the facility is therefore very essential because it might influence the quality, efficiency and the diversity of the services provided. There is need for consideration of the likely influential factors to the quality and the efficiency of the program. In the face of the increasing cost of healthcare, primary care can perform an important role by ensuring that they coordinate care for specialty services, while easing the situation for shortage of nurses and medical practitioners in the advent of increasing demand of healthcare. Ambulatory services have been used to provide outpatient services through the use of redesigned hospital ambulatory facilities, in the face of overcrowding at hospitals, wrong mix of services, problems related to equipment and personnel (Austin, Stephen, Williams & Ernest, 1997). Among the activities arising as a result of competition in the field of ambulatory services include purchase of medical practices, development of health plans and joint ventures (Warren & Annette, 2006). The paper presents a program for ambulatory primary care center. This ambulatory primary care program focuses on a community-based primary care and urgent care settings.
Components of the Program
Current demands in public health care require a diverse approach to solutions offered by clinics and medical institutions. Due to the diverse needs of the society as related to health needs of the individuals, it is important that institutions have a diversified approach towards providing health solutions in terms of biomedical services and educational programs. The primary focus of this initiative is to provide medical services to the residents. These services are of a wide scope and include provision of drugs for chronic illnesses, medical check-ups and clinical services. Provision of these services will be carried out by professionals who have been employed by the center and who have been considered competitive enough through training on the current needs, challenges and opportunities for ambulatory primary health care. In addition, the initiative will include provision of counseling services for the residents, social and emotional support. Professional counseling shall be available to groups who are interested after request, or after the individuals have been identified to require counseling following a medical examination or testing for chronic illnesses. The initiative will also involve creating awareness for the various types of chronic illnesses among the vulnerable groups and individuals through community educational health programs. Residents shall be made aware of the illnesses and diseases they are exposed to, exposure factors, ways they can prevent these illnesses, need to adhere to prescriptions, and how they can seek medical intervention for particular illnesses. The program incorporates not only biomedical health care, but also provision of medical training to residents, emphasis of medical ethics among practitioners and providers, improvement of health policy among others. Basic education shall be provided to recruited residents through ambulatory lecture curriculum on notice for the diseases identified as chronic. This is so as to equip residents with basic understanding of these illnesses. This training shall be aimed at ensuring enough practitioners are available for the community. The curriculum which shall take one year shall be designed to equip the recruits on how they can assist in providing patient care services and training needs at the community level. During this curriculum, the recruits shall be informed of the objectives of the lectures, learning outcomes and furnished with the necessary information on tests to be passed to them.
Under the Ambulatory Regulatory Program Administrator, the initiative will focus on the development of effective leaders in the ambulatory primary health care. This will be done through thorough and strict recruitment process for intake of professionals who are not only qualified in the field of ambulatory health care, but also staff in other diverse field related to the proper operation of the initiative. Effective leadership of the ambulatory primary center is very essential because it does not only ensure that there is proper management of the facilities but also that the quality of the services is not compromised. Leadership must be competitive so as to keep the center on toes with the current level of competition in the market, make sure that the services rendered are according to the current needs, and that the financial costs for the center remains as low as possible while not compromising on the quality. Leadership must be academically competitive individuals who understand ambulatory primary healthcare and the current needs and challenges for the institution. The leadership will be able to guide the institution to innovative practices such as integration with like-minded institutions which is essential to cutting down the cost. In addition, the expansion of the care facility will be largely determined by the competence of the leadership.
The modern community is no longer composed of people from one cultural, racial, traditional or religious background. In some cases, patients have preferred medical attendance on such basis, and therefore a need arises for healthcare institutions to make sure that these needs are incorporated into their programs. The current program will also focus on improving the needs for diversified community by emphasizing more on diverse cultural, traditional, religious and social-economic needs of the patients going through the initiative. With this in mind practitioners shall be drawn from the various cultural, traditional, religious and other backgrounds to make sure that there is a natural and basic understanding of these elements for the benefits of the residents to be served. In addition, because it may not be possible to schedule these practitioners based on their backgrounds, a program to train them on the various cultural, religious, traditional and other needs for their clients, shall be launched. The practitioners shall be required to serve the residents regardless of their social, economic, religious, traditional and cultural backgrounds(State of West Virginia).
Urgent care section shall aim to serve residents who visit the center with minor injuries, symptoms and illnesses before they are referred to specialized hospitals where necessary, and who require screening for various illnesses and diseases. Screening shall be carried out for cancer illnesses, simple radiology, allergy testing, diet control, pediatrics among other categories (State of West Virginia).
Opportunities for improvement
Rise in the healthcare cost in the current healthcare system present an opportunity for improvement of the ambulatory primary care as the latter tries to emerge with innovative ways that will reduce these costs. Opportunities to be explored include the alternative ways of funding. In order to make sure that there is reduced cost for the care services, the institution shall consider merging with other like-minded parties in order to share physical resources instead of building new ones unless where it is unavoidable. The institution shall therefore concentrate on linking the residents with hospitals for specialized treatments rather than major on providing specialized treatments. In addition, there shall be sourcing of medical equipments from established medical facilities such as the public health hospitals.
The initiative will aim at reducing burden for the society in the settings where members of the society cannot access medical services as a result of escalating medical costs and healthcare insurance coverage.
Potential for Growth
The result of more growth of ambulatory operations in the community may be a rise in the demand for techniques that introduce different relationship between the hospital and the physician, new financing models and new designated ambulatory leadership (Warren & Annette, 2006). Because of the benefits that could be harnessed by integration of different practicing institution in the field of ambulatory services, integration is therefore one of the potential areas of growth in this field. Integration can eliminate cultural, structural challenges in managing of primary care networks. Although integration has been a current practice in the field in order to cut cost and achieve other benefits, it is important that the institutions involved continue to focus on integration so as to achieve this and other benefits across the various communities involved. The institution will have to introduce innovative practices and systems that ensure measurement of quality and the management of chronic diseases. Because of the diversity in the healthcare which would require diverse working staff, there is a need for multidisciplinary approach to the patient-centered care (Warren & Annette, 2006). Academic Health Centers will have to carry out reforms in the current educational mission in order to end up with graduates who are ready and prepared to practice in the modern healthcare settings. The ambulatory care institution must therefore focus on making sure that the working staff is regularly updated on the current needs and settings in the healthcare as they arise. This will be carried out through retraining on intake, continuous seminars and funding individuals for higher education. In consideration that the clinical setting for the present has changed as compared to that of the past due to the technology advancement, rise in the aging population, and rise in the chronic illnesses, the staff will need training not only in the biomedical focus but also incorporated social, behavioral and cultural effects in the healthcare focus (Warren & Annette, 2006).
Expansion of the ambulatory primary health care services to the areas where there has not been wide venture is important for helping more people in the future. In addition, this presents a growth opportunity for the institution. Growth of institutions with a similar objective can be realized through integration. The institution will focus on integration with other organization to grow more and share facilities and staff to reduce on operating costs, overcome barriers such as cultural, religious and traditional, among other benefits (Esposito. et al., 2008). Strategic alliances will ensure that the institution continues to meet its objectives at a faster rate. Determination of these strategic alliances will be based on the current revenue and future revenue plans, delivery services and expansion plans among other criteria.
Projected revenue
Most of the program’s revenue will be sourced from the government as well as the non-governmental organizations. Some will be internally generated through prescription $ consultation fees charged directly to patients in their medical routine check-ups. The fees charged will be subsidized to ensure that they are affordable to all patients. The management will also establish chemist shops that will sell drugs for chronic illnesses to patients and outsiders at lower rates, also outlets for special facilities such as wheelchairs will be started. Health education programs to the community will be established aimed at generating some more revenues to the program. This will entail educating the general population on issues regarding medical health upon paying the specified amount of money as per the training session. Volunteer programs will play a vital role in supplementing the revenue earned. Here, students from every corner of the world will be encouraged to tour the region as volunteers and they will be charged a small fee.
There will be provision of counseling services to the emotionally disturbed patients at a fee. Mobile clinics will also be established in the sparsely populated regions. Cost savings from the government insurance schemes will act as a source of revenue as well.
Operationalization data
Collecting information (e.g. through questionnaires and interviews) from the target community will be a very important step in the operationalization data. This will help in establishing the community’s need in terms of medical care. Presentation and analysis of data will be helpful in the program’s establishment. Staffing needs in terms of numbers, building facilities (e.g. wards), catering facilities, patient’s clothing and medical equipments will be taken care of.
Population distribution patterns in this region will be very important in the program planning, a thing that will go hand in hand with monitoring the health care status of the region so as to identify the need (including lifestyle) of the target community (Buntin, et al., 2009).
Timeline
The program will take 14 months to be implemented fully. All these will be attained in 6 phases
Phase 1: This will entail gathering information on the region’s healthcare status. The process will involve collection, presentation and analysis of data. This will take place in the first two months.
Phase 2: The second phase will involve consulting with other stake holders i.e. government, non-governmental organizations and well wishers. The phase is expected to take place in the third and fourth month.
Phase 3: Here, all the necessary facilities e.g. buildings will be set up. It is expected to last to the 8th month.
Phase 4: The fourth phase will concentrate on staff recruitment and training. Academically qualified individuals will be recruited and later trained to ensure that they are up to the task ahead of them. This will take place in the 9th month.
Phase 5: This will be the implementation stage where all resources will be put into use. Every player is expected to deliver for the success of the program.
Phase 6: This will be the review period after one year of implementation. It will be a very important stage in the program’s assessment. Subsequent reviews will take place at an interval of two years thereafter.
Critical success measures
The accountability of the initiative both to the owners and the community is of paramount importance in meeting its objectives. This program therefore establishes a client and community perspective towards the assessment of the effectiveness of the initiative. Clients’ perspective is important in ensuring that the venture attracts and retains patients (Austin, Williams & Ernest, 1997). The initiative will concentrate on improving customer satisfaction and track the same. This is by making sure that the care provided is easily accessible to the residents and that it is assured. This availability is determined in terms of the hours of operation, availability of referral and consultation services and after-hours coverage. Physical surrounding of the facilities is also an important element in attracting and retaining of the clients (Esposito, et al., 2008).
Because patient scheduling is important in determining customer satisfaction, the program emphasizes efficient scheduling through scheduling and appointment system that will reduce waiting time for the patients and encourage efficient use of resources (Iezzoni, 2003). The program encourages the involvement of the government and other institution in the management of patient care through insurance coverage schemes and other financing options, in addition to requiring that the patients pay for their health care.
References
Austin R., Williams S. & Ernest J. P. (1997) Ambulatory care management. 3rd Ed. Delmar Publishers.
Buntin MB, et al (2009): Who gets disease management? Journal of General Internal Medicine 2009.
Esposito D, et al (2008). Impacts of a disease management program for dually eligible beneficiaries. Health Care Financing Review 2008; 30:27-45
Health Care Authority, State of West Virginia. Ambulatory Care Center Application. Web.
Kovner, A. R. and Neuhauser, D. (2004): Health services management: Readings, cases, and commentary (8th ed.). Chicago: Health Administration Press.
Iezzoni, L. I. (Ed.). (2003). Risk adjustment for measuring health care outcome. Chicago: Health Administration Press.
Polacsek et al., (2009). Impact of a Primary Care Intervention on Physician Practice and Patient and Family Behavior: Keep ME Healthy–The Maine Youth Overweight Collaborative. Pediatrics; 123:S258-S266.
Dr. Aileen María Marty has been dispatched to Liberia by the World Health Organization to help in combating the rapid spread of Ebola in some West African countries and in particular Liberia (Chardy, 2014). The country has been affected by the outbreak since March 2014. The three West African countries namely Guinea, Sierra Leone, and Liberia have recorded close to 1000 deaths so far.
The latest outbreak reports also indicate that more than three Americans have succumbed to the deadly Ebola virus. A total of 391 cases of Ebola have been suspected and confirmed so far. The number of deaths suspected to have been occasioned by the virus stands at 227 while109 cases have been officially confirmed after laboratory tests. More American experts are expected to be sent to the affected West African nations to control the outbreak (Millar, 2014).
In terms of the healthcare system, any group or segment of a population that is poorly incorporated in the established healthcare infrastructure is described as vulnerable. Some of the factors that may contribute towards poor integration of groups include health characteristics, geographical patterns or features, and the economic, cultural as well as ethnic aspects. A vulnerable segment of a population is deemed to be isolated if it cannot access basic medical care. Individual state of health may also be jeopardized owing to the high risks (Ferguson, 2007).
As already hinted, vulnerable groups are hampered from obtaining necessary services by several factors. To begin with, low income heavily contributes towards social isolation. Households that cannot afford the cost of accessing high-quality healthcare services are segregated along the poverty line. Another dominant factor is the ethnic and/or cultural practices of a given portion of a population (Ebola in Liberia, 2014). Certain cultural belief systems can potentially act as barriers to effective healthcare delivery.
For instance, some communities may not be willing or ready to embrace the latest advances in medical technology. Consequently, they end up entrenching themselves in ineffective curative methods. The personal health characteristics of individuals in society may also play a major role in aggravating the state of vulnerable populations.
Allocation of resources is also another key barrier that prevents vulnerable populations from accessing care services. Policymakers are not in a position to weigh the impacts of various healthcare programs adopted across the board concerning the available resources. While the vulnerable groups demand higher budgetary allocations than the rest of the populations, implementation is still a major challenge (Millar, 2014).
The onset of Ebola is similar to that of the flu. The infected persons are usually diagnosed with poor appetite, stomach pains, vomiting, diarrhea, general body weakness, aches in muscles and joints as well as headache and fever. The invasive procedures are minimized during treatment. Dehydrated patients should be supplied with adequate fluids and electrolytes. Anticoagulants are given to patients as part and parcel of treatment.
I work with abused children, the elderly, Lupus and HIV patients. Despite the critical social and emotional help required by these groups, I have noticed that stigma is a major setback in the progress being made to re-integrate these people into society. For example, HIV patients are hardly given any meaningful attention by the immediate communities. The elderly men and women also complain of being shunned by their relatives. Needless to say, the negative societal response to some of these vulnerable groups may continue to pull back the gains already made by social workers.
References
Chardy, A. (2014). FIU disease expert tapped for Ebola mission in Africa. Web.
Ebola in Liberia (2014). Web.
Ferguson, C.C. (2007). Barriers to Serving the Vulnerable: Thoughts of a Former Public Official. Health Affairs, 26(5), 1358-1365.
Millar, S. (2014). Ebola outbreak: US warns disease remains out of control as American aid worker returns for treatment. Web.
Arthritis is an inflammation of joints that results in pain in the affected joints and eventually, the pain spreads to the rest of the body parts. This condition is chronic and affects the elderly in society. However, even young people can suffer from this condition. There are different classifications of arthritis that depend on the part of the body of the joint, which they have affected. Arthritis makes the joint muscles stiff causing damage that leads to unnecessary fatigue that eventually translates into acute pain.
Definition
Arthritis is the most common cause of disability among many disabled people in Australia. This is because it causes the inability to move for the people suffering from the condition. The inability to move leads to further complications such as blood pressure, obesity, and eventually a heart attack. Arthritis is also a major cause of depression among the elderly. The condition comes in different forms namely, rheumatoid arthritis, gout arthritis, and osteoarthritis (VanItallie, 2010).
Osteoarthritis is the most common form of arthritis. It starts with minor pain when walking. The pain gradually develops into continuous pain that occurs even when one is not walking. Osteoarthritis affects the weight-bearing joints such as the spinal cord and pelvic joint. This condition is chronic in that there is no absolute cure and only measures to prevent the condition from worsening can be put in place. It is a risk factor for obesity, heart attack, and blood pressure conditions (Crosbie, 2007).
Rheumatoid arthritis is among the most common forms of arthritis. Unlike osteoarthritis, it is not only prevalent in the elderly but in all age groups especially those aged twenty years and above. This condition involves the body’s immune system responding against the body tissues and attacking them eventually causing damage. Among the body parts affected by rheumatoid arthritis are the cartilages and bones. It affects joints in the fingers, knees, and elbows. The condition too has no absolute cure, although when detected earlier and the patient administered with the right preventive medication, one can lead a normal and healthy life. In children, other symptoms of this condition may include body rashes and weakness, which results in inability to walk or handle objects with their hands (Felson, 2007).
Gout arthritis is another condition that develops when uric acid is deposited around the joints. In the early stages, it occurs only in one joint but if it is not controlled early, it may occur in all joints. It may lead to multiple inflammations making the affected person crippled (Ali, 2009).
Common experiences of those living with arthritis
Arthritis manifests in a number of ways. The first one is general tiredness where the victims indicate that they are suffering from malaise and general body weakness that hinders their normal movement from one place to another (Becker, 2005). The other symptom that affects people suffering from arthritis is the inability to use their hands or walk. The joint pains and morbidity of the bone tissues at the joint make it extremely hard for arthritis patients to move due to muscle strains at the stiffened joints and bones. Individuals suffering from arthritis also suffer from loss of sleep mainly due to the acute pain in the joints that makes them restless. It also leads to fever, muscle aches, pains and tenderness that make the bone too soft (Chan, 2011).
Issues affecting the arthritis patients
Since arthritis is a chronic disease, its treatment involves a number of different treatment methodologies. The first methodology involves physical therapy. This is where the patient engages in particular physical exercise recommended by the physiotherapist. Because the disease usually affects the joints, physical exercises are intended to ensure that the joints remain in place and enable the patient to cope with pain. The treatment may occur in the gym or at a place designated by the physical therapist (Applegate, 2008). The other type of measure involves having medical treatment to deal with the pain. In the case of rheumatoid arthritis, medication is required to stop the immune system from attacking its own body tissues (Bridges, 2010).
Due to the complexity of the physical exercise equipment to assist the patients in recovery and dealing with this condition, the treatment process is costly. Therefore, other forms of support for the patient suffering from this condition are necessary. The support for the patients includes family therapy where the family of the patients assist in physical exercise. The family also assists in meeting the medical bills of the patients (Wollenhaupt, 2008). This support is necessary because if the patients do not have anyone, support group or community to encourage them exercise the joints, their condition may worsen and lead to development of other risk factors such as obesity and heart disease. This means that there must be lifestyle adjustments for the patients if they are going to minimise the condition and its effect (Crook, 2006).
The other effect on the patients of arthritis regards the diet. Since the chronic condition affects the joints especially osteoarthritis, it is imperative to ensure the patients eat diets that help them remain healthy. This is because overweight patients tend to feel more pain than those with normal weight. The disease affects most of the weight supporting joints like the pelvic joints and the spinal joints. When the patient is overweight, the painful joints will have more stress than if the patient had normal weight (Witter, 2005). The diet factor assists the patients eat healthy foods that will help them maintain their normal weight even with reduced movements. The reduced movements may lead to obesity and heart attack if there is no alternative to assist the patient cope with the condition. The family support is imperative in ensuring that the patients follow the nutritionist instructions on how to keep the body fit irrespective of the reduced physical exercises and movements (Swash, 2007).
Self-management activities
The other support factor involves the creation of self-help groups where patients suffering from arthritis come together and share their experiences. Such forums may invite people who have recovered from arthritis and others who have managed to keep the condition at manageable levels (Vickers, 2008).
These support groups are common and assist in building positivity in the patient by providing emotional and social support that is significant in recovery (Hendey, 2009). Since arthritis especially among the young people is traumatic, most of the patients suffer psychologically and it may increase mortality rates if the patient does not receive social support (Hendey, 2009). The pain in the joints reduces social interaction and movement of the patient where without social support; the patient is likely to experience posttraumatic stress disorders such as nightmares and sleeping disturbances (Millar, 2008).
The other treatment measure involves water exercises where the patient exercises in water. These kinds of exercises are therapeutic to arthritis patients especially on those who feel fatigued and unable to walk under normal conditions. Walking in water especially in warm water is soothing and easier than walking on land. This helps the patients to keep the joints in shape without feeling extreme pain (Institute of Registered Myotherapists of Australia, 2012). The other physical exercise recommended for patients suffering from arthritis involves strength training. This involves engaging the body muscles and the joints in strenuous activities that will restore the joints to their normal body positions (Foltz, 2005). It may involve wrapping the joints with rubber bands and weight lifting. These excessive exercises should be in the presence of physiotherapist who will assist the patient during the exercises (Swash, 2007). Other than the physical treatments, other complimentary therapies supplement the physical therapy and keep the pain and other symptoms away. They involve use of natural food supplements such as fish oil for those suffering from osteoarthritis and krill oil for those suffering from rheumatoid arthritis (Braun, 2009). Other food supplements include ginger, pine bark extracts and acupuncture. They supplement the physical exercises by providing oil to the joints making it easier for the patient to move (Brewer, 2009).
The other preventive measure used to deal with arthritis is the massage therapy where patients massage their bodies. The massage enables the muscles to relax and is a therapeutic mechanism for the patients especially those with spinal problems. There are two types of massage therapists in Australia. Remedial therapists deal with patients who need such services and relation massage therapists assist the patients to relax especially those who are unable to rest or sleep (Australian Association of Massage Therapists, 2012).
Community’s resources
Individuals who live alone are at higher exposure of mortality because stress factors and social support may be lacking and yet they are necessary for people suffering from arthritis (Centres for Disease Control and Prevention, 2010). This explains why people living alone may have high mortality rates especially the elderly people with no one to take care of them. However, the elderly in Australia may survive longer because they have overcome the stress factors; have social support unlike the younger population that is exposed to stress factors and eventually cardiovascular disease, which results to death (Centres for Disease Control and Prevention, 2012).
Public health implications involve development of insurance policies to cater for the arthritis patients by assisting them with affordable treatment. Policies to incorporate the social support groups as part of the medication procedure will assist in the treatment of those suffering from this condition (Witter, 2005).
Conclusion
This condition is necessary to deal with due to its effect on the working population of Australia (Centres for Disease Control and Prevention, 2012). When people are not healthy, they are unable to perform their duties at the work place, which makes them less productive. Those suffering from this condition need sensitization on how to respond appropriately before they become susceptible to the risk factors such as heart failure, diabetes as well as depression. This problem is critical as it robs the country millions of revenues in labor costs and treatment procedures.
References
Ali, S (2009). Treatment failure gout. Journal of medicine and health, 92(11), 369-371.
Applegate, W. (2008). A randomized trial comparing aerobic exercise and resistance exercise with a health education program in older adults with knee osteoarthritis. Journal of the American Medical Association, 277(1), 25-31.
Australian Association of Massage Therapists (AAMT). (2012). Therapeutic massage for arthritis patients. Web.
Becker, A. (2005). Arthritis and allied conditions: A textbook of rheumatology. Sydney: Lippincott Williams & Wilkins Press.
Braun, L. (2009). Herbs and natural supplements: An evidence based guide. Sydney: Churchill Livingstone.
Brewer, S (2009). Overcoming arthritis: The complete complementary health program. London: Duncan Baird Publishers.
Bridges, P. (2010). Prehistoric arthritis in America. Annual Review of Anthropology, 21(2), 67-91.
Centres for Disease Control and Prevention. (2010). Prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation in United States, 2007-2009. Arthritis Weekly, 59(39), 1261-1265.
Chan J. (2011). Chronic arthritis treatment, juvenile chronic arthritis pain, chronic arthritis symptoms: Chronic arthritis treatment, symptoms and relief. Web.
Crook, D. (2006). Arthritis in Australia. American Journal of Medical Science. 7(2), 78–84.
Crosbie J. (2007). Physical therapy is effective for patients with osteoarthritis of the knee: a randomized controlled clinical trial. Journal of Rheumatology, 28(1), 156-164.
Felson, D. (2007). The lag time between onset of symptoms and diagnosis of rheumatoid arthritis. Arthritis and rheumatism, 37(6), 814-820.
Foltz, D. (2005). Alternative treatments for arthritis: The ultimate guide to herbs, supplements, bodywork and other complementary treatments for arthritis. Atlanta: Arthritis Foundation of America.
Hendey, G. (2009). Harwood-nuss’ clinical practice of emergency medicine. Sydney: Lippincott Williams & Wilkins Press.
Institute of Registered Myotherapists of Australia. (2011). Arthritis therapies. Web.
Millar, A. (2008). Action plan for arthritis: Your guide to pain free movement. Illinois: Human Kinetic Champaign.
Swash, M. (2007). Hutchison’s clinical methods. Edinburgh: Saunders Elsevier.
VanItallie, T. (2010). Gout: Epitome of painful arthritis. Metabolic Clinic Experts. 59(4), 32-36.
Vickers, A. (2008). ABC of complementary medicine. London: Wiley-Blackwell.
Witter, J. (2005). What can chronic arthritis pain teach about developing new analgesic drugs? Journal of Rheumatology. 6(1), 279-281.
Wollenhaupt, J. (2008). Undifferentiated arthritis and reactive arthritis. Current opinion in rheumatology, 10(4), 306-313.
The information obtained from the interviews suggests that Mr. Joseph is aging successfully. To a great extent, he meets the criteria for successful aging. First, he is satisfied with his past and expects his future to be good. He believes that each day is a gift and that one should enjoy life to the fullest. Secondly, he has a meaningful value system. For instance, he believes that honesty defines an individual. He hopes that his children and grandchildren will become honest people. Moreover, he is a religious man and he believes that it has helped a lot. Thirdly, he continues to maintain a meaningful social system. This is evidenced by his great sense of belonging. He lives with his grandchild. His children also take care of him. He also values the fact that his wife is still alive. Finally, he maintains a great sense of self-worth and dignity. He also has a positive self-concept. He believes that his health is good because he does not suffer from any chronic illness. He has a realistic perspective on his present and future health. He believes in seeking medical attention when necessary. However, he complains about the loss of financial independence. It appears that this does not bother him so much because his children and grandchildren are willing to help him. Parameters that can be used to evaluate successful aging include financial security, independence, absence of chronic illnesses, and ability to establish and maintain relationships with family members and friends. Mr. Joseph appears to have met the criteria to some extent.
Aging individuals may experience similar challenges regardless of where they live. Similarities between elders at home and those in hospital revolve around normal physiological changes. As we age, our cells, tissues, and organs get worn out. This leads to both structural and sensory changes. Sensory changes that all aging individuals experience include reduced visual and auditory acuity. Structural changes include loss of lean body mass and wrinkling of the skin. These changes can be found in both hospitalized and community-dwelling elders.
The notable differences between Mr. Joseph and hospitalized patients include a positive attitude towards life and unique adaptation characteristics. In the current case, the elder has a meaningful support system that helps him have a positive attitude towards life. It is common for elderly individuals to overly focus on death. Elderly individuals who live at home tend to have social, psychological, and financial satisfaction.
From the differences and the similarities between hospitalized and community-dwelling elders, it can be concluded that successful aging is largely influenced by their place of residence. That is, those at home tend to age more successfully than those who are hospitalized. However, some changes should be expected. Sensory and structural changes tend to occur regardless of the place of residence. However, coping and adaptation have a great impact on successful aging.
In the current scenario, it is evident that Joseph is proud of his life and the fact that he has raised his children well. For this reason, he is looking forward to seeing his great-grandchildren. This has increased his will to live longer. Therefore, it can be said that a community environment is better than a hospital environment. A community environment promotes the development of adaptive mechanisms. This is because there is a lot of supportive interaction in the community.
Senses (vision, hearing, touch) decline in old age: – I agree with this because various research findings have shown that these senses decline in old age. Reduced acuity in these senses (hearing and vision) tends to cause a considerable amount of distress.
Older adults tend to have more medical problems than the general population: – I agree with this because many health issues are frequently reported in old age.
I do not support the following myths:
All elderly people are alike: – it is an established fact that all human beings are different (owing to their genetic makeup and the environment in which they live). This individuality is not lost in old age. All humans continue to be different from one other in old age
Elderly people are incapable of making sound decisions: – the ability to think rationally is not affected by aging. In addition, learning and the application of knowledge are not limited by aging.
Elderly people have no interest in sexual activities: – research has proven that aging does not affect sexual activity. It only happens when there is an underlying condition. For example, the loss of a partner and the presence of a medical condition have been linked to loss of sexual desire.
Many elderly people are institutionalized: – less than 10 percent of adults live in nursing homes and other institutions. The majority of the older adults live at home either alone or with their relatives and children.
I have a more positive attitude towards aging. This is based on the fact that successful aging is influenced by how one copes/ adapts to changes that are experienced in old age. I believe that it is better to age at home where one can show and be shown affection.
Aging is enjoyable but lack of preparation and support can make it difficult.
Nursing plays an important role in the delivery of healthcare to an aged population. First, nurses should advocate for the continued involvement of older adults in family and community activities. The abilities of older adults should be assessed thoroughly. This is to ensure that they are not prevented from taking part in some activities. Involvement in day to day activities of the family and the community enhances the elders’ sense of purpose. They may feel worthless and dependent if they are not allowed to take part in community activities. Therefore, a nurse should assess older adults and advocate for their involvement in family and community activities.
Allowing independence and control during decision-making. In addition, they should be given the freedom to choose the kind of care they want to receive. Older adults should be accorded an opportunity to make their own decisions. Decisions that directly influence their health should not be made exclusively by others. This enhances their cooperation. Cooperation may lead to superior outcomes. Nurses should help older adults gain or maintain control over their care.
Another role that nurses have is advocating for community-based care of older adults. Older adults who age at home appear to age more successfully as compared to their institutionalized counterparts. An individual has a wider social support network both at home and in the community. Older adults tend to rate their success highly when they are surrounded by family members and friends.
Researchers and scientists have been preoccupied with developing medication to prolong people’s life and/or improve health. However, these measures may have long-term effects though people need immediate actions now. It is possible to improve people’s quality of life without huge investment into development of new drugs. It is crucial to focus on such urgent problems as social inequality and environmental issues in the contemporary society. These are two major determinants of population health.
People became aware of environmental issues decades ago, but they are still reluctant to see that immediate connection between environment and public health. According to Gehlert et al. (2008), environmental issues negative affect social environment, which leads to deterioration of population health. Admittedly, poor conditions (whole communities have to live in) have destructive effects on people’s health. Living near plants and factories increases the rate of such diseases as cancer, cardiovascular disorders, and so on. Natural disasters as well as negative effects of human activity also leads to appearance of areas inappropriate for living and people have to move to other place, which contributes to development of social inequality in communities (Closing the gap, 2008). Hence, it is important to make sure that environmental issues get the necessary attention and people are able to prevent, at least, anthropogenic disasters. It is crucial to invest into development of appropriate environment for people.
Another factor contributing to deterioration of population health is social inequality. As has been mentioned above, lots of researchers have focused on development of improving individual health, but this is affordable for a limited group of people. Notably, even countries with healthy economy (like the USA and the UK) are characterized by social inequality which is increasing each year (Wilkinson & Pickett, 2010). Only limited number of people can afford proper healthcare services. The rest of the population is deprived of their right to live healthy lives as they cannot afford healthy lifestyles (proper diet, exercise and so on). Constant financial constraints put people under constant pressure and this negatively affects population health. Poor population health is especially striking in the USA as the country spends unprecedented funds on its healthcare system (Bezruchka, 2010). Minority groups still get inadequate healthcare services in the country where the right to be healthy is seen as one of the most important values. Raphael and Bryant (2006) note that the state should focus on population health and come up with strategies to ensure proper healthcare services for all groups within the society. This may seem as a difficult task that needs a lot of funds. However, these funds can be relocated from multimillion pharmaceutical industry which works on improvement of individual health.
To sum up, it is necessary to note that two factors contributing to deterioration of public health are social inequality and environmental issues. These problems need immediate actions; otherwise the entire humanity can decline. Individual health can be a matter of research, but the contemporary societies require rapid changes aimed at diminishing social inequality as well as environmental issues. The state should focus on improving population health by introducing numerous incentives including promotion of healthy lifestyles and financial aid. The state should finally see that healthy citizens will be able to work hard to make the country develop and prosper. At present, it seems governments are more preoccupied with development of certain high-quality drugs which could help limited group of people, which is inappropriate in the twenty-first century.
Reference List
Bezruchka, S. (2010). Health equity in the USA. Social Alternatives, 29(2), 50-56.
Gehlert, S., Sohmer, D., Sacks, T., Mininger, C., McClintock, M., & Olopade, O. (2008). Targeting health disparities: A model linking upstream determinants to downstream interventions. Health Affairs, 27(2), 339-349.
Raphael, D., & Bryant, T. (2006). The state’s role in promoting population health: Public health concerns in Canada, USA, UK, and Sweden. Health Policy, 78(1), 39-55.
Wilkinson, R., & Pickett, K. E. (2010). The spirit level: Why greater equality makes societies stronger. New York, NY: Bloomsbury Press.
Cancer is a major health issue in low-income areas with medically underserved populations in places with no or few health care facilities and clinicians. There are disproportionate distributions of cancer health challenges in the US based on ethnicity, race, and socioeconomic status. Consequently, these factors have influenced morbidity and mortality associated with cancer in different ways. Hence, one must observe cases of cancer, diagnosis stages, prognosis, and patient outcomes.
At any given time, racial minorities, immigrants, and people within the lower socioeconomic levels fall within the medically underserved groups. Medically underserved groups believe that the health care system could be responsible for perpetuating health inequality. One could attribute effects of these disparities to several factors such as inhibition of cancer prevention, screening, detection, patient follow-ups, and subsequent treatment.
Several factors have contributed to barriers that affect the community. Majorities are underinsured or insufficiently insured, lack of cancer awareness programs, transportation barriers due to remote location of the community, busy rural ER clinical services, rural residence without permanent health care facilities, and lack of contact or relationships with health care providers.
Cancer affects African American disproportionately due to barriers responsible for inequality in health care provisions (Ferrante, Wu and Dicicco-Bloom, 2011). As a result, health care stakeholders have adopted various advocacy programs to improve provisions of health care services to medically underserved African Americans in rural locations.
A summary of advocacy program on the issue
Patient navigation (PN) has been a successful advocacy program for cancer patients. The program aims to lessen disparities in the provision of health care services by focusing on causes of disparities. It has focused on cancer prevention, screening and early detection, cancer treatment, and follow-up care among the medically underserved populations and locations.
Past studies have established that patient navigation was effective in enhancing health care outcomes among cancer patients in medically underserved locations (Robinson-White, Conroy, Slavish and Rosenzweig, 2010).
Attributes that made the program effective
Improving communication among cancer patients, health care providers, policymakers, survivors, and other stakeholders, including family and community members
Health care coordination
Providing financial support
Providing child care services and transportation
Keeping and arranging for the required medical records
Managing and facilitating treatments and follow-ups
Community involvement and outreach programs
Facilitating participation in clinical trials
A plan for health advocacy campaign that seeks to create a new policy or change an existing policy
Description
The new policy will aim to improve the provision of health care services for cancer patients in medically underserved locations among African Americans. Specifically, the policy will focus on the majorities at high risks of cancer complications and poor health. The policy shall focus on a twofold strategy approach by focusing on the relevant through addressing the immediate health concerns and possible future health challenges. At the same time, it will challenge the existing disparities in health care provisions, which have negative impacts on the quality of health and well-being among African Americans in remote locations.
Proposed policy solution: advocacy policy for change in health care provision
Reducing chronic cases of cancer among African Americans by cancer control risk factors
Promoting psychological and physical well-being
Supporting healthy aging in the community
Addressing inequalities in health care provisions in remote locations
Specific objectives of the policy
Identify inequalities in health care provisions as key factor that affects African American health status and well-being
Recognize that remotely located African Americans have diverse health needs based on their economic status
Prioritize changes in life stages as contributors to cancer
Identify the segment at high risks of cancer
Developing a system that is responsive to African Americans health needs by concentrating on prevention and promotion of healthy habits
Promote collaborative fight against cancer through program monitoring and evaluation by collecting and analyzing data and then sharing knowledge gained as a part of evidence-based practices
Address long queues in ER, which are significant barriers to health care provisions
Overall, the modification in policy should address reasonable insurance coverage and health care affordability to marginalized populations. At the same time, it should reduce the number of underinsured. It will also address the plight of health care providers, who work in such marginalized environments. The goal is to enhance investments in rural health care facilities to address long-term health care outcomes among medically underserved populations. It would also increase awareness programs in remote locations.
Methods of establishing support for the policy
This policy shall rely on collaborative processes. Hence, it shall account for health needs of the immediate beneficiaries and engage decisively with politics in policymaking processes. Political decisions heavily affect health care provisions and well-being of this segment of the population in remote locations. The policy shall adopt reliable support and use of reliable information in order to develop efficient and effective processes of solving cancer among African Americans by analyzing societal health problems and public policy affairs. On this note, the policy shall:
Engage internal stakeholders in all processes
When internal stakeholders participate in all processes of policymaking, they will own and feel as a part of the entire policy. Involving internal stakeholders earlier will ensure that the policy identifies and addresses major health concerns in the location. Late engagement and discovery of the challenges may impede the progress of the policy.
Internal stakeholders will provide valuable insights in the development processes to avoid surprises in the later stages of policy implementation.
Realistic expectations
The policy shall develop trust among stakeholders through open processes in order to establish realistic expectations among stakeholders. The policy shall ensure that personal feelings, differences in opinions and distrust do not affect the process negatively.
Identification of all stakeholders
Although the policy shall have key stakeholders, it will not ignore other important stakeholders in health care provisions. Hence, it will account for all stakeholders’ roles, agendas, objectives, and expectations. In every project, there are always important stakeholders who must agree with the project. In addition, there are also others, who may pose the greatest threat to success of the policy. The project shall categorize all stakeholders based on their levels of importance at all levels. Moreover, it will focus on needs of stakeholders at all levels. This would ensure absolute support for the new policy.
How to influence policymakers
The policy shall use best practices and successful programs of the past based on data to influence policymakers. For instance, the policy will cite examples of success programs based on the study by Sara Rosenbaum, Emily Jones, Peter Shin, and Leighton Ku (2009). This study established that advocacy programs reduced health care disparities significantly among the medically uninsured and underserved populations (Rosenbaum et al., 2009). It will also identify weaknesses in the current policy in order to improve on them, such as uninsured and underinsured, lack accessibility to healthcare facilities and financial support.
Application of attributes to the policy
The policy shall apply the best attributes of patient navigation among cancer patients in order to reduce health care disparities. It will adopt health care provision for change and long-term outcomes by addressing the immediate concerns and long-term challenges. On this note, the policy shall use multidimensional approach, collaborative processes, monitoring and evaluating, financial support and management, and other supports needed.
Legal considerations
Modifying the existing legislation
The proposed policy seeks to modify the existing policy on health care provisions based on its weaknesses and inadequacy to serve African Americans in rural areas with cancer. The points of interests, which the proposed policy seeks to modify in the current policy, include the following:
The current policy does not provide funding for the uninsured and additional funding for the underinsured. The modification shall advocate for funding allocation for this medically underserved population.
The existing policy does not acknowledge the unique health needs of African Americans in remote locations. The proposed modifications shall account for low-income status of the population, lack of accessibility to health care facilities, and poor health promotion in the region.
The policy shall improve on the current one by being progressive through putting African Americans on the political agenda in order to improve their health status and well-being.
The policy modification shall focus on key areas, which the existing policy has not addressed effectively. These shall include adequate funding, availability of health care facilities and care providers, accessibility of the area, healthy aging, and racial impacts of health care provision.
How existing laws could affect the advocacy efforts
This is a public health policy issue. Hence, it is under the current laws and regulations that guide the provision of health care services to all communities. These laws and regulations could be formal, informal, and other influential decisions that local, state, and federal entities make. The role of the current policy should address several interrelated public health challenges either directly or indirectly and develop a guideline that provides a framework for responding to challenges among African Americans in remote locations. The current policy has failed to highlight challenges that the community faces and assist in determining how stakeholders should respond to these needs under the law. Responses would include provision of health care services, changes in legislation, and financial support among others.
Therefore, the advocacy and public policy must work collaboratively in order to identify and set forth the required changes so that they can address these needs. There should be no competition because advocacy will act as a factor for facilitating or influencing public policies for change. Exchange of information will be effective for the program.
Analysis of the methods used to influence lawmakers and other policymakers
Heath care provisions should not be apolitical because inputs and supports from legislators and policymakers are crucial for the success of the program. Political processes should not compromise professional standards or affect relationships among health care stakeholders (International Council of Nurses, 2008). Racial prejudice against African Americans in the past could influence their opinions about involving politicians and policymakers in the process. Therefore, the role of the advocate is to ensure that such thoughts do not interfere with the belief in the project. The nurse must make the community to acknowledge the role of politics in the process differently, as supporting rather than opposing.
Politicians must understand that they make policies, which determine behaviors, choices, and the provision of health care services among African Americans in remote locations. The major role of advocacy is to change such policies that politicians and policymakers make. In this case, the health care resources are in the hands of few. This has led to poor provisions and distribution of health care service to the racial minorities in remote locations.
Advocacy for modification of the current laws would ensure that the medically underserved groups gain recognition for their health challenges. In addition, the effort would also influence lawmakers to ensure equitable distribution of health care resources in order to solve immediate and long-term health challenges among African Americans in remote locations.
The challenge could be how to influence lawmakers to modify the current policy. On this note, the advocate shall review how policymaking process works by focusing on comprehending how lawmakers make and enforce public policies (Milstead, 2011). This would allow the advocate to understand important decision-makers who need to be influenced in the process of modification of existing legislation.
Identifying key decision-makers, policies they implement, the level of consultation, accountability, and responsiveness
Understanding how public policies are implemented and enforced
Persuasion with facts on health care disparities and their negative effects on African Americans
Gaining direct access to key decision-makers on public health issues
In case the responses are poor from lawmakers, the disruption and litigation may influence lawmakers and other policymakers.
Obstacles
The article has highlighted few obstacles associated with political processes and provided solutions in the above section. Nevertheless, there are still some. For instance, local authorities cannot change any laws at the grassroots level even if the conditions of African Americans advocate for the need to modify public policy on health care. On this note gaining accessibility to key decision-makers at the national level may take time. However, prior planning may alleviate such challenges.
In some instances, political leadership may resist any changes to the current policies. Therefore, the advocacy program shall adopt two basic for legislators. The program shall combine both condemnatory and collaborative approaches in order to address such challenges. The process shall involve highlighting health discrepancies within the current policies and proposing the best alternatives that would offer the desired health outcomes to African Americans in remote locations. If these approaches fail to work, then the program shall adopt disruption and litigation.
Ethical consideration
The US Constitution protects the right to advocacy or lobbying under the First Amendment. Hence, nurses and communities have rights to participate in decisions that influence their lives. However, it is important to address ethical issues in lobbying.
Fairness
It is unethical to pay or influence policymakers’ decisions by paying or compensating them in any ways to favor the modification of the policy. Receiving payments for other expenses incurred to support a policy is not a fair practice. Hence, the advocate shall not pay or compensate legislators for expenses incurred due to the program.
The ease of accessibility to legislators is also a major source of concern. People at the remote location lack fairness when it comes to gaining accessibility to lawmakers. This is critical when others can easily gain easy access to them. The nurse shall make prior arrangements with key decision-makers in order to enhance chances of accessibility.
Local leaders may also attempt to influence the advocate to drop the bid to change the policy. The nurse shall remain professional throughout the process and avoid personal and private concerns of others.
Transparency
Lack of transparency could present ethical dilemmas to the process. One way of avoiding lack of transparency is to register and file all matters explored in the meeting with all stakeholders, including legislators. The advocate shall enhance frequencies of reporting and open processes with all meetings with policymakers.
The advocacy shall avoid ‘earmark strategy’ i.e., last minutes rush so that policymakers can study the proposed modifications and provide their inputs (Berry and Brown, 2007). The advocate shall ensure that the proposed modification have all relevant details and sufficient time for reviews.
Common Good
Health care lobbyist shall represent the common good of health care provisions among medically underserved in rural locations. Hence, the role of the advocate nurse would be to provide facts about the desired modifications at all levels of policymaking. There should be no compromising on public good.
On the other hand, the advocacy shall ensure fairness to policymakers by engaging them in the process to understand their inputs. This is a process of ensuring that the common good for African Americans remains and presented at all levels of policymaking. Hence, different views are necessary to develop strong modification objectives for the existing public policy.
Ethical laws and reporting requirements for the advocacy program
The nurse shall ensure ethical practices throughout the lobbying process. One way to ensure ethical standards is to ensure that all stakeholders understand the process of lobbying and important decision-makers who can influence the process. Hence, the nurse will register and file a report on all matters discussed with all stakeholders during advocacy.
The nurse would also maintain the NAN codes of ethics by focusing on integrity of the profession, practices, and self-integrity in order to shape public health policies. This would improve health care environments for medically underserved and uninsured African Americans in remote locations living with cancer. Moreover, it would improve conditions for health care provisions in remote areas and reflect the value of the profession (American Nurses Association , 2011).
Ethical challenges unique to the population
Africa Americans in this area are racial marginalized segment of the population. Hence, advocacy program must recognize their socioeconomic status, beliefs, racial considerations, and other factors that could influence their beliefs and behaviors toward health care policies, politicians, and advocacy.
The advocacy program shall recognize unique needs of African Americans with attention to their gender, ages, socioeconomic status, and race. As a result, the new public policy shall rely on the discourse of the target beneficiaries and not views of lawmakers alone.
All adopted policies shall be applied with absolute concerns to race and other characteristics, which make African Americans in rural areas different from the rest. The aim is to reduce health care disparities in the current policy and include the needs of the minorities in the modification.
Ferrante, J. M., Wu, J., and Dicicco-Bloom, B. (2011). Strategies Used and Challenges Faced by a Breast Cancer Patient Navigator in an Urban Underserved Community. Journal of the National Medical Association, 103(8), 729–734.
International Council of Nurses. (2008). Promoting Health: Advocacy Guide for Health Professionals. Geneva, Switzerland: ICN.
Milstead, J. A. (2011). Health Policy and Politics: A Nurse’s Guide (4th ed.). Burlington, MA: Jones and Bartlett.
Robinson-White, S., Conroy, B., Slavish, K. H., and Rosenzweig, M. (2010). Patient navigation in breast cancer: a systematic review. Cancer Nursing, 33(2), 127-40. Web.
Rosenbaum, S., Jones, E., Shin, P., and Ku, L. (2009). National Health Reform: How Will Medically Underserved Communities Fare? Web.
Measuring the population health is a significant action in aiming at advocacy and the means to boost health, reducing health care expenses and decreasing the dilapidation extent of life that puts at risk the future life of people (Olopade et al., 2008). Traditional epidemiological measures entail risk contacts, prevalence, multi-sphere measures of population health state, and the rate of deaths in determining the population health.
Main body
Traditional epidemiological approaches and extensive population-founded determinants have similar objectives. They both help in determining the population’s health to boost the population’s attributes. Conversely, epidemiological measures emphasize underlying research and quasi tentative outline. Traditional epidemiology does not represent the appropriate measurement of population health. There is no coherent tackling of significant methodological factors on the subject of clear conceptualization and the connection of measures of population health.
On the other hand, the population-based approach makes use of a definite population as the coordinating factor for deterrent accomplishment that targets the widespread of diseases and health determinants (Hurty, 1933). Population-based factors make use of community information as the factual foundation for societal intervention programs (Hurty, 1933). Above all, a population-based measure of health population includes the following attributes, population perspectives, experimental epidemiology (use of community-obtained data), fact-founded actions, putting the focus on efficient results, and putting the focus on initial deterrence.
The wide population-focused determinants that affect the health differences and imbalances object to the traditional strategy of evaluating community health. The population-based method to measuring population health provides crucial ways of characterizing the intricacy of the health of the people in the community. This is by unveiling the risks that affect the population, the spread, and the evaluation. Population-based measurement as well provides a significant platform for invention and studies that link varying spheres of research significant to community health. This is to contribute to the advancement of crucial and equivalent ways of evaluating population health and the determinants.
Population-founded determinants are the easiest way for formulating population health for instance percentage of the members of a community with distinctive forms of illness or diseases, particularly medical conditions, or the percentage of individuals in distinctive communities who lose their life in distinctive time frames on significant grounds. The population-based measure quickly turns out to be challenging to the traditional approach for assessing population health especially when several problems exist, and individuals need to come up with evaluation in the fullness of time, over community groups or previous to and after several health intervention programs (U.S. Department of Health and Human Services. (2010).
Conclusion
In conclusion, my response to put into consideration population determinants, to evaluate population health entails improving the entire measuring process. The possibility of boosting the health of people in a population and advancing the chances of evaluation and accounting for population health is essential. These modes of measurement will require a link to an apparent theoretical framework and incorporation of connections flanked by the varying factors of population health. The use of population determinants to measure population need to play a role in the entire population health objectives. For instance, it needs to boost the health of the people and decrease the health disparity. The health indicators need to back up this objective via adhering to significant factors, which include advocacy, liability, quality advancement, management of the organization, and scientific approaches.
References
Gehlert, S., Sohmer, D., Sacks, T., Mininger, C., McClintock, M., & Olopade, O. (2008). Targeting health disparities: A model linking upstream determinants to downstream interventions. Health Affairs, 27(2), 339-349.
Hurty, J. N. (1933). The fence or the ambulance. American Journal of Public Health Nations Health, 23(8), 796.
Education and population-wide ‘health behaviour change’
Ideally, education alone is insufficient in prompting effective population-wide “health behaviour change”. Despite the efforts exerted by governments, health activists, and other health organizations so as to provide vast education on health matters, limited health behaviour changes have been attained. Evidently, most people have not fully embraced the principles of living healthy (Kovner, Knickman & Jonas, 2011). Some individuals still go against the conventional health requirements. This occurs regardless of their educational standards. For instance, statistics indicate that many people across the world still smoke despite the warnings against cigarette smoking. Consequently, there is a high prevalence of lung cancer and liver infections. Even though there is adequate information on how to practice and maintain viable eating habits, most individuals hardly eat sensibly. As a result, a lot of diseases, that could otherwise be avoided, still threaten the human race.
In this context, there is still a high prevalence of HIV/AIDS across the world despite the education carried out on how to avert its spread. Unprotected sex is still rampant regardless of the education attained against it. Although information from the internet, books, journals, and other sources indicate that daily physical exercise is a necessity for healthy living, a number of people do not exercise. Thus, they are affected by diseases like diabetes, obesity, and coronary ailments (French, 2010). Unhealthy behaviours like excessive drinking of alcohol increase the chances of acquiring liver diseases and cancer. Moreover, people are supposed to maintain some levels of hygiene. Nevertheless, some individuals have failed to do so despite their knowledge of the consequences. As a result, there are still high incidences of cholera infections. Due to these ineffective health behaviour changes, there has been a dramatic increase in mortality. A lot of people die at an early age simply because they have ignored the relevant information regarding healthy living, public health, and sanitation. Precisely, these arguments indicate how education alone has not promoted effective healthy living within societies. There is still more to be done so as to attain the desired health standards. This is a considerable provision when scrutinised critically.
How politics has influenced the population health behaviour change
Various health policies enacted in various countries have significantly contributed to ineffective “health behaviour changes”. Due to politics, prostitution is still legalized in some countries. This has greatly propelled the spread of HIV/AIDS and other health concerns. Additionally, some governments have not provided enough condoms and viable protective measures due to poor governance and dreadful politics. This has greatly contributed to negative health behaviours. Contextually, most people are still having unprotected sex. Despite the adequate programs and education on the prevalence of HIV, there are insufficient policies enacted to deal with this epidemic (Kovner, Knickman & Jonas, 2011).
Besides, there are fewer alternatives for the treatment and prevention of chronic diseases due to inconsiderable policies, dire politics, and misdirected interests. Various health rules and regulations enacted by the government can greatly affect the health behaviour of an individual. People staying in countries without strong smoking and drinking rules might smoke and drink uncontrollably (French, 2010). Additionally, due to unstable politics, there are limited health facilities hence most people do not seek medical attention in hospitals when they are sick. Similarly, it is agreeable that people who are unable to access good meals, clean drinking water, and medical facilities might experience poor health. This can be contributed to the government’s failure to provide affordable health provisions and sustainable public health. This indicates that not only education can enhance health behaviour change but also other political influences. Additionally, some governments have failed to establish family planning measures.
Economic influences on population-wide health behaviour change
Due to economic inequality, some individuals are not able to access clean water, medical provisions, and other health provisions. Eventually, this has led to poor health among the concerned societies. Besides, health conditions (like obesity), which are caused by poor diet and lack of physical exercises are some of the major causes of death. These can be prevented by practicing and embracing good public health (Browning & Thomas, 2005). Due to high health costs, many people are not able to access viable medical provisions. Additionally, the affordable costs of alcohol and cigarettes have led to their excessive consumption. This indicates the noticed negative health behaviours (Browning & Thomas, 2005). In addition, despite educational dominance, most countries cannot afford to provide the necessary health provisions for their citizens due to economic instability. Many people living in rural areas are not able to eat healthy foods due to poverty. Additionally, most families are in constant fights over domestic wrangles promoted by poverty. This has led to increased cases of mental illnesses. Besides, economic factors have greatly influenced the health behaviour of the entire population and the society at large. Precisely, the economic status of a country or a given population can influence its behaviour change despite the levels of education.
Effect of psychology on health behaviour change
Psychologically, the behaviours of some individuals hardly relate to the levels of their education. Many people in society have been affected by their emotional mindsets. This has resulted in negative health behaviour. Arguably, it is evident that many individuals who come from families where parents take alcohol tend to be more vulnerable to alcoholism compared to those who come from non-alcoholic parents (Elder, 2001). Most people have a mentality that smoking offers an excellent opportunity to relax thus helpful in relieving stress. Psychologically, it is believed that individuals whose previous generations had suffered from chronic infections like cancer, diabetes, and hypertension will also experience such health complications.
Many individuals hardly take certain nutritional foods. They psychologically doubt their viability or they sometimes believe that such foods were damned by society. It is possible to psychologically condemn some health issues despite their applicability. This can occur regardless of the educational levels of the concerned individuals. Besides, there are behavioural conditions, which have negative effects on the overall physical health of a person (French, 2010). People have bizarre thoughts when it comes to certain diseases like HIV/AIDs. They always believe that no one can survive once affected by the disease. Consequently, they hardly search for the remedial measures available.
How does philosophy affect the changes in health behaviour
Philosophy has a considerable effect on the “health behaviour change” mentioned earlier. For instance, in the American context, people have failed to balance their healthcare costs with the quality of medical provisions they access. As a result, many people go for cheap but compromised medical facilities instead of supporting the Medicare scheme for quality health provisions (Elder, 2001). Additionally, various studies carried out indicate that HIV is factual; however, most individuals have hardly honoured this fact. It is crucial to conclude that education alone is insufficient in prompting effective population-wide health behaviour change as argued earlier.
References
Browning, C. & Thomas, S. (2005). Behavioural change: An evidence-based handbook for social and public health. Edinburgh: Elsevier Churchill Livingstone.
Elder, J. (2001). Behavior change & public health in the developing world. Thousand Oaks, CA: Sage Publications.
French, D. (2010). Health psychology. Oxford: BPS Blackwell.
Kovner, A., Knickman, J. & Jonas, S. (2011). Jonas & Kovner’s health care delivery in the United States. New York, NY: Springer.
Health insurance has become an important form of security in the modern world. In a country like the United States, health insurance is sought part of being a US citizen and has become a basic necessity for the population. With this thought, there are still millions of people that are uninsured and form one of the biggest social and public sector issues today. Solutions to this problem come in all forms but only a few can be logically implemented, accepted, and benefit all parties.
Solutions
There are several planned, proposed, and potential solutions to the issue of uninsured people. These are mainly different ways of covering the uninsured and vary in cost, philosophy, and methodology. Some of these are discussed briefly as follows.
The basic idea is to provide health benefits and insurance for all Americans. This can be done only when there is willingness and participation from all influential actors including the healthcare provider and the patient. Controlling costs will result in efficiency and a greater share that can be used on the solutions to this problem through proper managerial practices and infrastructure. This can also be done by the simplification of the administrative side of the healthcare sector. Finally, affordable solutions for both the public and the private and public financers are the key to proper implementation and running (Battista).
One of the basic solutions is to use the federal funds to cover uninsured people several hundred percent below the poverty line. This will redirect a chunk of the federal funds towards healthcare expenditure, which is the only problematic aspect although it would somewhat lower the uninsured population.
High deductible health insurance is another solution that will help the uninsured through healthcare savings accounts and will use taxes to fund coverage solutions. Another basic but large-scale solution is a single large pool of healthcare that all US citizens will be a part of, which will be publically funded. Another small-scale solution with limited effects would be to mandate employers to provide health insurance to employees that work for a certain amount of time during a week. Like these, several other solutions have been proposed by experts but only a few can be applicable. (Healthcare coverage in America: Understanding the issues and proposed solutions).
Present solutions
Currently, few of these solutions are being implemented. That does not mean that nothing is being done about the uninsured issue, just that the current solutions are a little different than the ones mentioned above, which seems ideal (Kennedy).
The current measures being taken are similar yet different. The new US administration is focusing on higher discount rates from drug companies to medical insurance providers. Among the solutions mentioned above, redirection of federal funds is being proposed with the idea of funding medical research and financing the insurance-providing pool for the public. This also includes expenditure on outreach programs that help the issue of immigrants and minority uninsured people (Robert).
Plan to implement solutions
In my view, a good plan to start the solution chain for this problem would be the proper reallocation of federal funds in favor of healthcare research and insurance coverage. At the same time, in parallel, the US administration needs to plan out and implement a single publically funded pool and provide health insurance for all US citizens at nominal rates, a system similar to the Canadian counterpart (Varnon).
Works Cited
Battista, John R. “Solving The Problem Of The Uninsured.” 2004. Connecticut Coalition for Universal healthcare.
“Healthcare coverage in America: Understanding the issues and proposed solutions.” 2008. cover the uninsured.org.
Rob Varnon. “Many arguments, few solutions to growing problem of uninsured Americans.” Connecticut Post (Bridgeport, CT) (n.d.). Newspaper Source. EBSCO. [Library name], [City], [State abbreviation].