Policy-making in healthcare is a complicated process where different parties are involved. It is important to understand that nurses are essential members of the medical team who can see the flaws of the healthcare policy through their everyday work. Therefore, registered nurses (RNs) and advanced practice registered nurses (APRNs) should be aware of their policy-making opportunities and be able to suggest their ideas. Even though they do not usually take an actual part in policy-making, they can influence the decisions of legislators. For example, Burke (2016) recommends RNs explore the general principles of policy-making and contact different nursing organizations, such as AARP. She states that it is always possible to volunteer to participate in policy-making activities and prepare a report on the necessary changes to present to decision-makers.
APRNs are more experienced, and therefore, may have a greater influence on decision-making. The problem for both RNs and APRNs may be the lack of knowledge on how to address legislation-related issues (Houskova, 2018). Burke (2016) emphasizes that a nurse should always seek opportunities to increase knowledge in this field by exploring related resources. Moreover, participation in conferences and nursing associations is a good way to discuss these issues with colleagues and exchange experience.
Legislators confirm that the engagement of NPs and APRNs in policy development is vital, but their opportunities are not addressed properly. One of the solutions would be to raise awareness of these opportunities through professional nursing organizations (Patton et al., 2018). It is also possible to form coalition groups to advocate for nurses’ engagement and collect their opinions about the current public policy (Patton et al., 2018). Another strategy is connected with the lack of nurses’ knowledge about the general principles of policy-making. American Nurses Association California suggests providing its members with necessary educational material and continuous support (Houskova, 2018). Together, these methods would demonstrate the opportunities for RNs and APRNs and increase their involvement in the policy-making process.
References
Burke, S.A. (2016). Influence through policy: Nurses have a unique role. RNL. Web.
Houskova, M. (2018). Nursing engagement in policy development and advocacy. DNP Qualifying Manuscripts, 11, 1-22. Web.
Patton, R.M., Zalon, M.L., & Ludwick, R. (Eds.). (2018). Nurses making policy: From bedside to boardroom (2nd ed.). Springer Publishing Company.
The aging population in Canada is increasing at a very high rate, following retirement of the baby-boom generation. As a result, there is allegedly excessive strain on healthcare as the older adults require medication than younger people. This necessitates increase in taxes or cut in services to the public. However, while aging population in the society may be considered a health care concern, Mythbusters (2011) suggests that factors that increase the costs of health care such as technological innovation cost should be given the primary consideration as they are more consequential.
Why is this important issue?
The issue of aging of the population is very critical, especially because it becomes worrisome when the health expenses increase and policymakers left with a dilemma on what to focus on in addressing the situation. They keep wondering whether the aging population per se is the real cause of the trouble, but it becomes important to consider the concrete cost drivers while charting out corrective policies. After all, experts’ evidence shows that the aging population’s contribution to the steadily increasing expenditure on health care is very minimal. It is therefore critical to understand the main cause of the health care expenditure increase rather than attributing it to aging population without much certainty or information. Furthermore, good understanding of the real factors that drives the cost of healthcare provision is very important when controlling the healthcare budget (Mythbusters, 2011).
Do you agree or disagree?
I strongly agree with the issues set out in this observation, mainly, the fact that the cost drivers require our foremost attention. Despite the disagreement in regard to the exact factor that requires greater attention, the cost driver that results from technology and prescription of drugs is a major factor that has increased healthcare expenditure for several years. Many experts have actually cited out new medical technology and drugs prescription expenditure as an overriding contributor to the swelling of overall health expenditure, notwithstanding the recent phenomenal decline in expenditure on drugs prescription. In addition, information technology (IT) is the other influential technological cost driver that has had dramatic impact on health spending. Increased use of electronic medical records (EMR) has been allocated hefty budget with the intention of improving efficiency of healthcare service delivery. This has actually been a central agenda in many health reform plans (Mythbusters, 2011).
My opinion is fundamentally supported by the analyst’s declaration that application of state-of-the-art; expensive technological services as well as new drugs stimulate health care expenditure. This observation is made with due acknowledgment that the industry must recoup the development costs of such products and for the reason that they stimulate consumer demand for stronger and expensive services regardless of their cost-effectiveness. Having this in mind, I would envision that any national health reform efforts should have the aforementioned costs as the central element of consideration (Mythbusters, 2011).
Furthermore, sustainability of healthcare shows that utilization surges have a strong relationship to the medical and technological developments. In conclusion, as the population of the aged surges, it has been observed that the health care cost increases in tandem but when analyzing this more carefully, it is found that the impact of aged population is rather minimal. I contend that the policy debates must continue having healthcare costs at the forefront-as the policymakers chart out the way forward with the mission of enacting comprehensive healthcare reforms.
Reference
Mythbusters. (2011). Myth: The aging population is to blame for uncontrollable healthcare costs. Web.
Human health is a priority to individuals, communities, non-governmental groups, governments, and international associations. An effective planning process addresses the current and future needs of the people. Human health is an essential requirement, and individuals should invest in their well-being while the government lays necessary measures to provide health services primarily to vulnerable groups. The vulnerable population living at high health risks includes children, the poor, the aged, and people living with disabilities (Trusted Choice Team, 2020). The individuals in these categories have greater chances of being affected by chronic and other adverse infections due to their weak body immunity. Therefore, they should be protected constantly bypassing health bills that simplify their access to medical care. This study’s scope will be limited to a health policy relating to the geriatric population using Milio’s approach.
The geriatric population is composed of the least productive members of society. Although they pay taxes during their years of employment, they no longer participate actively in the economic building at their advanced age. The World Health Organization (WHO) states the right to health as a claim to a set of structures that ensure everyone enjoys the rights (Baer et al., 2016). Governments should initiate healthcare measures that provide the aged access to health care services at a reasonable cost. Some of the steps may include providing health insurance plans for the aged and other health determinants such as proper housing, a clean environment, and sanitization. The provision of preventive measures for chronic diseases, pain-relieving medicines, and enough public healthcare institutions with quality services also favors health care for the geriatric population.
Milio’s Policy Process
Milio wrote resourceful materials discussing the health sector’s improvements and other industries that can promote healthy living. She states that the physical environment and behavior patterns significantly impact either promoting or hindering healthy living (Super et al., 2020). Some of the tools discussed by Milio as health-enhancing policies in other sectors include the development of social epidemiology, improved health education and health economics, and information technology (Super et al., 2020). She also discussed the role of love and power in promoting healthy living. Milio’s approach is applied in this study to examine the role of the environment in health-enhancing among the elderly societal members.
The Environmental Policy
Knowing an individual’s physical environment is crucial in preventing and controlling some diseases and infections common during old age. Prevention of some illnesses would be a better measure compared to managing the condition or even treatment. The geriatric population is very vulnerable to multiple functional impairments. Healthy living can be attained by maintaining a clean physical environment, a well-balanced diet, and access to social, and moral support. The geriatric population should be settled in places free from pollutants such as air pollutants, noise, harmful chemicals, unclean water, and residential areas, free from toxic metal contents such as mercury and aluminum (Fachbibliothek Umwelt, 2017). Therefore, policies relating to reliable, effective, and efficient health care of the elderly in their physical environment should be formulated.
Some human-triggered and naturally-caused changes in the environment are causes of some health problems. Environmental changes such as high air pollution and high ozone levels are harmful to the human breathing system (Fachbibliothek Umwelt, 2017). Less concern about health care is directed to the environment, while much effort and funds are invested in the other measures to maintain a healthy environment. The geriatric population is very vulnerable and should not be exposed to a harsh climate. Therefore, health policies concerning maintaining a healthy environment should be formulated.
In addition to the living conditions, the environmental factor should be considered compared to the accessibility of medical care. The geriatric population is affected by many health problems which require close medical check-ups and regular clinics. The check-ups may involve visiting a health care facility or the physician visiting the patient at their homes. The American Geriatrics Society (2020) supports implementing a policy on assisting the geriatric population in fighting Covid-19 through the establishment of Assisted Living Facilities (ALF). The policy would ensure that the elderly have close access to medical care and treatment by relocating to a residential where they can be taken care of in a better way.
This study supports the Assisted Living Facilities (ALF) policy to be implemented fully considering the health factor instead of Covid-19 infection. The policy would be sustained by the Medicare program and some individual costs to pay for the rental residence. The family members of the person under medication would take care of them during the treatment period, providing meals and other basic needs. Care and time from family members ensure both moral and physical support, which Milio was advocating for.
Inconsistence of the Policy
The main challenge facing the implementation of environmental policies on geriatric population health is inconsistency in service delivery. Poor planning has delayed the implementation of government policies on maintaining a pollution-free environment and Assisted Living Facilities (ALF) may not be fully implemented. Moreover, they are not entirely acts of mercy but mainly compensation for people’s health insurance plans. The policy demonstrates discrimination and unfairness since it is implemented effectively to the affluent members who have heavy insurance covers while delayed or denied to the poor who are even more vulnerable.
Conclusion
Therefore, the geriatric population can have better lives if the necessary measures for preventing and controlling infections are put in place. A healthy environment should be free from hazards and pollutants, access to medical care, and enough physical, material, and moral support from family members. Therefore, governments should formulate and fully implement policies relating to the environment of the geriatric population.
References
American Geriatrics Society. (2020). American Geriatrics Society (AGS) policy brief: COVID ‐19 and assisted living facilities. Journal of the American Geriatrics Society, 68(6), 1131-1135. Web.
Baer, B., Bhushan, A., Taleb, H. A., Vasquez, J., & Thomas, R. (2016). The right to health of older people. The Gerontologist, 56(Suppl 2), S206-S217. Web.
Trusted Choice Team. (2020). Senior health insurance. TrustedChoice. Web.
Fachbibliothek Umwelt (2017). Environmental pollution and diseases of the elderly. Umweltbundesamt. Web.
Super, S., Klerkx, L. W. A., Hermens, N., & Koelen, M. A. (2020). A multilevel transition perspective on embedding intersectoral action in local health policies. Health Promotion International, 1-12. Web.
There is a multitude of moral and ethical issues to be found in the inadequate provision of health care on community, city, and state levels to the incredibly underserved homeless population within the United States. Ethical issues can be described as the moral challenges that people face in the course of decision-making (Stanhope & Lancaster, 2016). On the other hand, ethical dilemmas are based on moral justifications for different courses of action, such as choosing where to allocate resources in the face of two populations in need. Underserved populations can be described as those lacking adequate socioeconomic and psychosocial resources to meet the standard of a healthy community (Stanhope & Lancaster, 2016, p. 715). Members of these populations are more likely to develop health problems than their more fortunate counterparts due to greater exposure to cumulative risks and tend to suffer more from them.
One of the most at-risk and underserved populations within the United States is homeless persons. Homelessness negatively affects the well-being of individuals, families, and communities, and not addressing this issue is a severe moral failure on the part of communities and governments. One of the most valuable resources for this population, which must be made available at a broader level, is healthcare. Homeless people are beset by complex and often dire health problems brought about by lack of proper rest and nutrition, exposure, infections, diseases, trauma, mental health problems, and much more (Stanhope & Lancaster, 2016, p. 741). This is a moral and ethical issue, as homelessness is primarily driven by an increase in poverty levels and lack of affordable rental housing, which is both brought on by and can only be tackled at community, city, and state levels. (Stanhope & Lancaster, 2016). There is no ethical dilemma to be deliberated over in the decision to provide greater resources and funding for better health care access to this population, and the failure to do so is a moral failing.
References
Stanhope, M. & Lancaster, J. (2016). Public Health Nursing: Population-Centered Health Care in the Community (9th ed.) Elsevier Mosby.
The nursing population tends to increase in diversity, prioritizing the need to encourage inclusion and equity. To ensure that nurses can provide effective care, it is critical to establish an environment that welcomes differences and considers them as resources. First, it is necessary to define diversity within a certain community of the nursing workforce. Namely, it is important to clarify the expected outcomes of promoting diversity, formulating them clearly and understandably (Mason et al., 2020). Education of the nursing personnel contributes to building awareness among nurses, which can be achieved during group discussions, nurturing difficult conversations, and addressing prejudices against diversity. Recruiting nurses should include clarifying the terms of inclusion to engage them in the established environment. The nursing workforce should be multinational, which implies recruiting minorities in nursing programs. One of the examples is recruiting the LGBTQ+ community members and developing the relationships between them and other nurses.
Those with privilege should be encouraged to help others become active members of a team. At the same time, those who lack privilege can be given more opportunities to get involved with community outreach (Villarruel et al., 2015). For example, many Spanish and Asian patients with poor English language knowledge struggle to understand their treatment details. In this case, nurses from similar ethnic/racial backgrounds can be assigned to these patients to prevent misunderstanding. Such an approach allows for promoting better interaction in the team and leads to positive patient outcomes. Among other barriers that would potentially be addressed by means of the diverse and inclusive nursing workforce, there is patients’ lack of health literacy and poor access to health care.
References
Mason, D. J., Gardner, D. B., Outlaw, F. H., & O’Grady, E. T. (2020). Policy & politics in nursing and health care (8th ed.). Elsevier Health Sciences.
Villarruel, A., Washington, D., Lecher, W. T., & Carver, N. A. (2015). A more diverse nursing workforce. The American Journal of Nursing, 115(5), 57-62.
Healthcare issues are witnessed all over the world due to the lifestyle and the prevalence rates for various infections. Once a population is affected by a given health issue, there is a need to have urgent, critical, and concrete attention so that the matter would be leveraged adequately. Heath problems are challenging especially due to the policies that may be lacking and also the implementation strategies put in place. In the US, the Centers for Disease Control and Prevention (CDC) follows the sensitive public health problems. CDC has reported that approximately 17% of adults smoke which translates to 40 million people in the US (Hall & Doran, 2016). Although the percentage is declining in the last ten years, smoking is still a health issue and a significant concern to the citizens of the country. Tobacco usage in the US is the leading cause of preventable disease and death. This paper assesses tobacco use as a health problem in the US population.
Summary of the Problem
Smoking in the US is an issue that needs to be intervened for the better health of the population. Tobacco, being a leading cause of preventable disease and disability in the US, has led to many deaths in the country. More than 1600 persons under the age of 18 try to smoke for the first time every day (Hall & Doran, 2016). Nearly 200 out of the first group end up being addicted to smoking whereby approximately 480,000 deaths are recorded in a single year (Lee et al., 2021). Those who do not die remain with a smoking-related illness which costs society over $350 billion annually (Lee et al., 2021). If there are proper ways to prevent the issue, the costs could be reduced and help youths to have a healthy life.
The challenge of smoking is based on the body organs because there is a distortion of the normal way of functioning for the heart, the liver, and lungs. Additionally, as a result of smoking, cancer, stroke, and type 2 diabetes are also realized. There is a need to have the population advised on the ways to control tobacco usage so that people would be having better conditions health-wise (Lee et al., 2021). The study is important for a baccalaureate-prepared nurse since it helps in realizing the changing environment of tobacco use in the population. The project exposes an individual to basic skills in nursing theory, roles of clinical leaders, healthcare metrics among other benefits.
Analysis of Evidence from Peer-Reviewed Literature
There is existing research done by various authors on the issue of tobacco use. An article by Robinson et al. in 2017, explains why the health problem matters by highlighting the effect, the risks involved, and the drawbacks to the society at large. The content enlightens the reader about the current issues that lead to smokers having higher risks of severe illness from chronic diseases. More than 16 million people in the US live with a disease that is a result of smoking (Robinson et al., 2017). Smoking is associated with respiratory diseases, for example, chronic obstructive pulmonary disease. Smoking not only affects those who smoke but also the group that does not use tobacco.
When a person is exposed to secondhand smoke, they may be at risk of dying. An estimation of the number of non-smokers who die due to the exposure is about 41,000 deaths as per the statistics derived from CDC (Robinson et al., 2017). Recently, there has been an increase in the familiarity with e-cigarettes among teenagers and youth. The most affected group by this health problem are men as opposed to their female counterparts. Adults from 18 years to 44 have been affected as compared to those who are older (Robinson et al., 2017). This literature addresses the significant barriers to the implementation of proposed steps to ending excessive smoking as the lack of strategy that can make the matter feasible. Therefore, when the states embark on the policies, it becomes hard to navigate the matters due to the absence of a streamlined and open course of action.
Some projections clearly show that many people have been affected. Through the research by Rodu & Plurphanswat article of 2017, the population aged between 18-40 years is at risk of getting smoke-illness relates problems. Anyone who has ever smoked at least 100 cigarettes can be defined as a smoker (Rodu & Plurphanswat, 2017). People with a general education certificate have the highest tendency to smoking with a low number among the degree graduates. Those with a low income rate are actively smoking compared to the middle- and high-class population.
The data would be unreliable if the samples used in the articles’ results are not well distributed based on the methodology. For instance, if the study’s main target was the older group that consists of only men from one ethnicity and social class, therefore, the data would be unreliable. The article explores the challenge towards implementation of reduced smoking rate among Americans as the pressure from the technology (Rodu & Plurphanswat, 2017). Many people watching films and the latest music genre term smoking as a fashion that is targeted to influencing others. Therefore, when young people smoke, they relate to what they learn online hence make the implementation a challenge for that matter.
This project targets to work with the population aged 23-40 years and largely men during the study. The group will provide basic and important information that can be reliable. The project shall have distributed samples having clusters to represents different blocks. For instance, men aged 23-28 years will be used to represent the young adults while 39-35 years can be used to cover the middle-aged adults. The reason why the study focuses on research about the smoking issue through the group is that at that age, people are known to have distinct traits on nutrition and may be obsessed with their choice of what to do (Lee et al., 2021). On the contrary, young people at teenage may not yet have discovered themselves while the older group start to conform to the health regularity requirements due to the weak immune systems.
The US Government Policy on Smoking
The government has imposed various policies that are made e-cigarettes, especially among young people. In 2019, Congress passed Tobacco 21 legislation that prohibits people under the age of 21 from buying tobacco-related items with inclusive of e-cigarettes (van Dorn, 2017). The policy has been implemented within 24 states and it helps regulate the rate of usage of tobacco in the US. The government has been on the move to help the population from the risks of cancer, heart disease, and possible deaths due to the addictive use of tobacco.
The government banned all flavors in all tobacco products such as methanol which has been in the market for a long while. Without flavors, young people may not have attractions from the cigarette hence one way of regulating smoking. For the population that this study focuses on, it is important since the life expectancy will be increased hence having few cases of people dying from the usage of tobacco (van Dorn, 2017). On a different note, training nurses to practice proper standards in nursing will help to reduce the prevalence of tobacco-related issues. With the nurses equipped with information and expertise power, they can assist the population by giving them the adverse effects that may be as a result of smoking.
Leadership Strategies to Aid in Leveraging the Health Problem
Optimization of processes across the healthcare field is important when controlling smoking issues. That means the US healthcare firms can opt to merge or partner with program developers for ending the increased rate of smoking. In this case, there must be collaborative bases between healthcare organizations and other concerned firms in educating the public about the dangers of smoking frequently (Lins et al., 2018). Through the leadership strategy, there is the likelihood to hinder complications as a result of tobacco use. Through the efforts, the firms will standardize processes that are conforming to clinical protocols which can assure consistency of health welfare.
The other leadership model that can be useful to help bring changes through the proper metrics for reducing the smoking problem is sustaining employee engagement during the change institutionalization. 40% of hospital staff are considered engaged but they are not well enlightened to push for the changes in health issues (Lins et al., 2018). When healthcare leaders manage to engage employees by letting them focus on drivers of change, the outcome will be significantly positive. For instance, healthcare workers can be given the liberty to research and develop frameworks that can lead to reduced instances of smoking among the group aged 23-40. In that way, nursing practitioners will be boosted with the skills to intervene during healthcare problems.
Collaboration and Communication Strategies to Address Smoking
The government of the US can boost the healthcare workers by providing expertise and people with information power on healthcare issues. The collaboration can be through the CDC and private medical sector with the inclusion of communal sensitization groups on the welfare of the population. To have effective change on smoking issues, there is a need to clarify the campaign goal to hospitals and the public who can understand the need to combat the problem. The message should be strategically expressed through materials such as daily prints, mainstream media, and social media platforms with the relevant subject (Hall & Doran, 2016). The important strategy here is to monitor the success and evaluate the potential risks and benefits that may be evident when tobacco use is regulated. The insights must be from the health professionals that have been on the frontline to change the nutrition requirements.
Practicum Focus Sheet
This project targets to work with the population aged 23-40 years and largely men during the study. The group will provide basic and important information that can be reliable. By interacting with the group, it will be possible to learn their habits in terms of responding to health problems such as smoking in the US. Through the study, it is easy to know the challenges that may make the problem escalate in various parts of the country.
The idea on the health problem in terms of the discoveries made through research will be presented to the group through scheduled programs that will engage them together. To ensure that the issue is familiar to them, convening a sensitization meeting will work towards drawing the attention of the group to the problem. It can also be presented through announcements that can be made from respective administration points of mass media to ensure the group under the issue, challenges, and risks associated with tobacco use.
Leadership skills that can be used when working with the Optimization of the process to make sure that the community as a whole will be partnering with healthcare firms towards combating smoking problems within the country. The collaboration shall be between the society and the government through policies set such as limiting the age that someone can purchase the drugs (Lee et al., 2021). Communication shall be through enticing the group by presenting the information by use of lectures and seminars. Change management skills used in this case shall be in terms of monitoring the progress and deciding the perfect way to end challenges that have the potential to arise.
The possible barriers may be consumerism habits that may lower the motive that is set towards reducing the rate of tobacco use in the country. Due to trends in buying behavior, there might be influential behaviors whereby youth will tend to follow what they see online or from popular people. To combat the barriers, the study proposes that the group shall be enlightened about the distinct ways in which a buyer can get information about a certain product through an expert (Lee et al., 2021). Thus, it means the group shall be advised to always listen to a physician before making decisions that are catalyzed by the peer pressure of bodily demands.
The life expectancy of people and the health of the population have geographic differences, which is the reason for the ZIP codes paradigm. The study by Holmes et al. (2018) examines differences in life expectancy by geographic area in Hawaii. The authors emphasize that the life expectancy of the population varies in geographical zones, but they do not investigate the factors influencing these disparities. However, Graham et al. (2015) emphasize that despite the identification of disparities, this theory does not allow addressing the causes of their occurrence. The researchers note that there is now a need to look at social and economic data across communities and neighborhoods. This article identifies the existence of a relationship between ZIP codes and population health but also emphasizes the limited nature of the information presented by it.
Health disparities are more local in nature and need to be studied from the perspective of more diverse variables. Goodwin et al. (2016) identify that areas that are medically underserved are characterized by a higher mortality rate for people admitted to hospitals with severe sepsis. However, the study highlights that “ZIP Code-based surrogates of socioeconomic status including median income, proportion below poverty level, and educational attainment, however, had a minimal association with sepsis mortality” (Goodwin et al., 2016, p. 1). Thus, the researchers note that access to health care, rather than socioeconomic conditions, plays a key role in infection mortality. This article provides an opportunity to consider additional factors that affect health indicators beyond ZIP codes. These findings are also supported by Graham (2016), who argues that the health of a population is determined by the interaction of many factors, including social, geographic, individual, and environmental. Thus, the ZIP codes paradigm is not a reliable representation of health disparities that exist in society.
Researchers are also attempting to view health predictors in terms of more specific geographic characteristics. The study by Airaksinen et al. (2016) examines the relationship between the neighborhood in which people live and their habits. Research results identify that people in urban areas are more likely to smoke and drink alcohol. Urbanization and socioeconomic status do not affect people’s engagement in physical exercising activities. At the same time, the study notes that urban residents are more interested in monitoring and maintaining their health, including healthy eating behaviors. Thus, the study identifies social causation between neighborhood and health behaviors. However, the researchers note that the findings are relevant to Finland, which has a rather homogeneous social environment.
Researchers are also paying increased attention to research on social determinants that affect population health. Obuobi et al. (2021) investigate the relationship between the social conditions in which people live and the risk of cardiovascular disease. In particular, the researchers note that such factors as “housing stability, food insecurity, transportation limitations, utility assistance needs, and interpersonal safety” (Obuobi et al., 2021, p. 984). The results of the study allow analyzing what motivates the geographical differences in the health of the population within the framework of the ZIP codes paradigm.
Other studies also support the assumption that health disparities depend on ZIP codes but are also socially determined. Qwaider et al. (2021) note that “patients with colorectal cancer residing in lower-income areas are screened less, received adjuvant chemotherapy less, and have worse outcomes” (p. 1). Thus, the ZIP code correlates with the income level of the population, which affects access to medical care and health outcomes. This study makes it possible to identify the relationship between this characteristic and social conditions, which are determinants of health. This finding is supported by Ritchie (2013), whose article emphasizes that geographic health disparities are more influential than genetic characteristics of individuals. In particular, it is noted that the habits of human life and social determinants play a more significant role than access to health care.
The researchers emphasize that ZIP codes illustrate well the social conditions in which a person lives and which determine individual health. Slade-Sawyer (2014) argues that social factors such as income, housing, and education can be much more important for the health of the population than the quality of the health care system. Seavey (2008) argues that poverty and disease have a complex relationship, as the poor are more likely to get sick. He argues that people living in poorer communities often have no job and health insurance. Thus, poor people tend to be in poorer health due to the inability to get help.
Thus, a review of the literature makes it possible to identify that ZIP codes correlate with disparities in the health of the population. Based on the information provided, two hypotheses can be presented that correspond to the research questions. Firstly, the geographic health disparities provided by the ZIP codes paradigm are related to the socioeconomic characteristics of the areas. Second, socioeconomic factors have a greater impact on the health of the population than the quality of the health care system. These hypotheses reflect the findings reflected in the literature review and allow us to investigate how ZIP codes reflect the health status of the population.
Graham, G. N. (2016). Why your ZIP code matters more than your genetic code: Promoting healthy outcomes from mother to child. Breastfeeding Medicine: The Official Journal of the Academy of Breastfeeding Medicine, 11, 396–397. Web.
The Challenges of Transcultural Nursing: Purnell Model
At the time of internationalization, the standards of nursing undergo significant changes. Some of the population sub-groups, such as minorities, foreign patients, or other people with different values and beliefs, are often underserved or misunderstood in medical institutions. Therefore, doctors, nurses, and other medical personnel need to adapt to the cultural peculiarities of certain sub-groups. Purnell model is a theory aimed at a comprehensive assessment of a population sub-group and raising medical workers’ awareness about cultural diversity and corresponding medical approaches. This model is actively used in transcultural nursing and other spheres, such as education, and contributes to understanding how cultural differences influence behavior and decision-making.
Chinese Migrant Population: Description and Rationale
The choice of the Chinese sub-group is explained by the presence of Chinese culture in many countries of the world due to the increased immigration rate leading to the demand in transcultural nursing. Besides, Chinese culture is significantly different from European or American, which makes serving such patients in these regions challenging. The highest number of people in the world belong to Chinese culture, and the Chinese population is aging. The major culture-based healthcare problems are connected with insufficient language proficiency and low health literacy among Chinese and unawareness of medical personnel about the peculiarities of Chinese culture. Therefore, it is important to identify the distinctive features of this sub-group to evaluate its possible health-related approaches.
Purnell Model Assessment
Traditions and heritage play an important role in Chinese culture. Due to the high population of China and consequent active immigration, the culture is present in many other countries of the world. Complicated language is considered the main obstacle in communication with such patients. For nurses, it is important to understand that facial expression, body language, and eye contact are highly important for an interpersonal connection. Family is the most important value in Chinese culture. Both mother and father in a family have their own responsibilities. However, it is mostly a masculine culture, which means that a male plays a more significant role in decision-making; older people in the family are also highly respected. As for workforce issues, the most widespread difficulty is the complicated Chinese language and difficulty in acculturation.
China is the most populated country in the world, with the growing tendency of urbanization. As a result, its unfavorable ecological situation leads to a high level of water, soil, and air contamination. Hereditary diseases are frequent among the Chinese and should be taken into account. Another consequence of urbanization is connected with the spread of high-risk behaviors and unhealthy habits among the Chinese, such as smoking, drinking, and substance use. Although a healthy diet is important in Chinese food culture, frequent use of food supplements and high-calorie products may lead to diabetes, obesity, or poisoning. In general, pregnancy problems among the Chinese are connected with unfavorable ecology and individual unhealthy behavior such as alcohol consumption.
Religion and spirituality play an important role in Chinese culture. For example, burial is perceived as the act of bringing peace to the dead, and inhumation is the most widespread death ritual for the Chinese. Chinese people pay a lot of attention to praying and religious practices. According to the traditional views, blood and qi energy flow maintain life in a human body. Traditional Chinese medicine also sees health as a balance between body, mind, and environment of an individual. In Chinese medicine, much attention is given to enhancing the resistance of an organism to diseases. Therefore, group training, outdoor exercise, and other ways of health promotion are rather popular among Chinese, especially elderly people. All healthcare practitioners are very respected in the analyzed culture; inclination towards Western or Chinese medicine is individual.
Local Community Healthcare Issues
Due to the high population and immigration rates, the Chinese sub-group is present on all continents. For example, Tsoh et al. (2016) confirm the growing migrant Chinese population in the U.S. Chinese migrants often have no medical or injury insurance and suffer from deterioration connected with self-treatment. The tense social and economic situation in migrant families can lead to frequent stress and mental diseases, in addition to nutrition deficiency. Moreover, at the local level, a high level of pollution and insufficient regulations over food supplies may result in food poisoning, diabetes, obesity, and related problems. If there are no opportunities for proper physical activity in a community, it may also contribute to the problem of weight gain.
Global Community Healthcare Issues
There are also diseases that are closely connected with the unfavorable environmental situation and the consequent global health deterioration. The developed transportation and industry have a negative impact on the overall health condition of the Chinese. For example, air, soil, and water contamination may lead to defects in newborn children and reproductive diseases in adults. Moreover, air pollution, exhaust fumes, and industrial emission contribute to respiratory diseases, such as asthma. Cancer and cardiovascular issues are also common among Chinese people. Finally, although today a healthy lifestyle is a popular trend among people of all ages, an unhealthy diet and more frequent use of food supplements lead to obesity and diabetes.
Many of the global health issues are connected with the changing lifestyle of Chinese people. According to Li et al. (2016), urbanization is a widespread tendency, and many people move to cities from rural areas. Life in the city, however, requires a lot of energy; therefore, everyday stress and overwork may lead to depression and other psychological issues. Sedentary jobs and lack of proper physical exercise result in obesity. Sexually transmitted diseases and unhealthy behavior, such as tobacco, alcohol, and drug consumption, are also connected with the fast-paced urban life. Hypertension is considered another widespread issue in Chinese culture.
Recommendations
The Purnell model analysis of the Chinese migrant population demonstrated that this sub-group belongs to a culture with a specific attitude to health, medicine, and traditions. First of all, it is necessary to overcome the linguistic barrier with the help of an interpreter or translator, if needed. Then, doctors and nurses need to understand that family involvement is highly important in the whole process of treatment. It is important that decision-making in a Chinese family is often the responsibility of men or older people. Besides, culturally competent medical workers need to be polite and patient with Chinese people to reach mutual understanding and meet patients’ demands.
During treatment, nurses need to evaluate the social and economic environment of patients and possible related conditions. It is important to understand the importance of traditional medical practices for Chinese and the effect they may have on the patients. Nurses need to take into account the psychological condition of migrants and local and global ecological factors influencing patients’ overall well-being. Finally, diet and unhealthy habits of individuals may cause some of the health problems. Provided that all these factors are considered, nurses can comprehensively evaluate the health condition of Chinese migrant patients to define proper medical approaches.
References
Li, X., Song, J., Lin, T., Dixon, J., Zhang, G., & Ye, H. (2016). Urbanization and health in China, thinking at the national, local and individual levels. Environmental Health, 15, 113-123. doi:10.1186/s12940-016-0104-5
Mou, Y. (2017). Predicting the use of traditional Chinese medicine: Health maintenance approach from cultural and spiritual perspectives. Journal of Religion and Health, 56, 971–985. doi:10.1007/s10943-016-0299-3
Purnell, L. (2018). Update: The Purnell theory and model for culturally competent health care. Journal of Transcultural Nursing, 30(2), 1-8. doi:10.1177/1043659618817587
Tiechuan, M. (2016). A study on non-verbal communication in cross-culture. Asian Journal of Humanities and Social Sciences, 4(1), 1-6.
Tsoh, J.Y., Sentell, T., Gildengorin, G., Gem, M.L., Chan, E., Fung, L.-C., Pasick, R.J., Stewart, S., Wong, C., Woo, K., Burke, A., Wang, J., McPhee, S.J., & Nguyen, T.T. (2016). Healthcare communication barriers and self-rated health in older Chinese American immigrants. Journal of Community Health, 41, 741–752. doi:10.1007/s10900-015-0148-4
Xi, J. (2016). Cultural differences and similarities between China and Brazil: A comparative analysis using Hofstede’s cultural dimensions. China and Latin America in Transition, 227–242. doi:10.1057/978-1-137- 54080-5_13
This presentation covers different aspects of influenza preparedness. It describes the disease, vulnerable populations, and how communities can protect themselves from it.
Abstract
This paper explores influenza preparedness among public housing residents and low income communities.
Public housing residents and low income populations often report negative health outcomes.
Preparedness for influenza needs to occur at personal, policy and community levels.
In summary, this paper highlights the multi-level strategies that communities could use to manage and prepare for influenza.
Learning Outcomes
Formulating culturally competent preparedness and response interventions that address specific needs of public housing residents and low-income population groups.
Improving public health and community health preparedness against influenza.
Improving multi-level preparedness against influenza.
At the end of this presentation, we should learn the importance of promoting socially competent health care interventions for preventing influenza. This goal should help to improve the public health and community health preparedness against the pandemic.
Introduction
Pandemic Influenza is a serious health concern (Ostrem and Horsburgh, 2008).
It can cause death and permanent health damage.
Vulnerable populations are most prone to the disease.
This paper investigates how low-income populations and people living in housing projects could prepare and respond to the pandemic.
Pandemic influenza affects different types of people. However, this paper mainly focuses on how low-income groups and inhabitants of housing projects could prepare and respond to the disease.
What is Influenza?
Influenza is a respiratory tract infection.
Complicated cases of influenza may cause pneumonia and other complicated health issues (Osterholm, 2005).
Pandemic influenza may be severe and affect many people, as opposed to seasonal influenza (Osha, 2009).
Before embarking on the details of this presentation, it is important to understand influenza as a respiratory tract infection that requires immediate treatment. Unlike seasonal influenza, pandemic influenza is more dangerous to human beings.
Factors Influencing Vulnerability To Pandemic Influenza
Pandemic influenza occurs because of poverty, inequities in health status, poor access to quality health care, and low immunization rates among other factors.
Types of Virus
Influenza virus A.
Influenza virus B.
Influenza virus C.
There are only three types of influenza as shown in this slide. Types B and C do not cause pandemics, but type A does.
Influenza Transmission
Influenza is airborne because it is transferred through coughs and sneezes.
Influenza can also be transmitted through contact with contaminated surfaces and bird droppings.
Airborne aerosols cause the most infections (Compans and Orenstein, 2009).
Pandemic influenza spreads fast because it is airborne. Airborne aerosols cause the most infections to human societies.
Why Focus on Public Housing People?
The US Department of Housing and Urban development funds operating procedures of more than 3.4 million public houses (Bouye et al., 2009).
There are about 1.5 million people living in these public houses and most of them have low-incomes.
They live in congested areas.
Inhabitants of public housing are more vulnerable to pandemic influenza because they form a significant percentage of the US population that lives in abject poverty and reside in congested areas. These dynamics support the spread of the disease.
Why Focus on Low-Income People?
Low-Income people often juggle multiple jobs and could skip vaccination because of limited time (Rocheleau, 2013).
Low-income people could avoid seeking health care because of demanding work schedules.
Low-income people live in congested areas that often lead to the faster spread of influenza.
Similar to inhabitants of public housing, low-income people often have multiple jobs that either prevent them from seeking quality health care treatment, or influenza vaccinations.
Address to the Public How to Care for People with influenza
Keep a care log.
Keep the patient rested.
Keep tissues and trash bag close to the patient.
Use ibuprofen or acetaminophen or other measures, as recommended by your healthcare provider.
Make sure patient does not drink and smoke (CDC, 2008).
Give patient plenty of fluids.
Do not use aspirin because it may cause the Reye syndrome or a life-threatening illness.
Watch out for signs of dehydration.
Watch out for complications of influenza (Meltzer, 2008).
It is important for the public to protect themselves from influenza. However, when they have to take care of infected people, they need to understand how to keep a care log, keep the patient rested, and make sure the patient does not drink or smoke. These measures help to manage the disease and minimize its spread.
Since many influenza patients vomit, people should give them plenty of water and watch out for signs of dehydration. Care givers should also refrain from administering other drugs, such as aspirin, because they may cause new health complications.
Address to Public Housing Residents
Residents of public housing should be more concerned about influenza because they live in crowded places, they suffer from chronic health conditions that could affect their immune systems, they suffer from severe mental health conditions (compared to the general population) that could affect their treatment, and may not seek care until they are very sick (Armstrong, Berlin, Schwartz, Propert, Ubel, 2001).
Inhabitants of public houses are often vulnerable to influenza because they live in unfavorable conditions that may support the spread of influenza. For example, most public housing projects are overcrowded, thereby supporting the spread of influenza. Similarly, personal health factors, such as adverse mental health conditions and the predisposition to stress factors also make them vulnerable to influenza.
Address to Low-Income Populations
Develop family and personal preparedness plan.
Attend health education training programs.
Stockpile supplies.
Refine personal infection control policies.
Put hand sanitizers in conspicuous places.
Forge crucial partnerships with health agencies.
Low-income populations need to take proper care to prevent themselves from influenza because they are more vulnerable to the disease, compared to people from other income groups. In this regard, they need to develop their family preparedness plans, attend health education training programs, and forge crucial partnerships with health agencies. Personally, they need to stock emergency supplies, refine personal infection control policies, and put hand sanitizers in conspicuous places. These measures would improve their preparedness to influenza.
Address to Low-Income Populations (What Everyone in the House can do)
Wash hands with soap and water.
Do not touch hands, nose, or mouth without washing hands first.
Wash soiled utensils with hot water (using hands or dishwasher).
Wash Clothes in a standard washing machine with cold or hot water.
Clean home surfaces regularly.
Most measures for preventing influenza should involve all members of the house. They include personal hygiene factors such as washing hands with soap, refraining from touchin contaminated surfaces, washing clothes in standard washing machines, and cleaning household surfaces regularly.
Address to Policy Makers
Make influenza vaccinations mandatory for people in public housing projects.
Vaccinate farm poultry to reduce infection rates.
Increase channels of communication between community members and healthcare service providers (Blumenshine et al., 2008).
Policy makers should make sure they support the efforts of health care workers by introducing legislations that make vaccination mandatory for inhabitants of public housing projects and low income groups. They should also stretch the same policy to include all poultry. Lastly, they need to create legislative measures that increase the channels of communication between communities and health workers.
Role of Department of Health
Disease surveillance and reporting.
Case Investigation and Management.
Identification of influenza cases and following up on afflicted individuals.
Health risk assessment and communications.
Liaison with other stakeholders in the health sector.
Vaccine distribution (Stoto, 2008).
The Department of Health plays the most important role in influenza preparedness. It should conduct disease surveillance and reporting, investigate infections, assess health risks to human populations, distribute vaccines and provide recommendations for preventing future infections.
Community Interventions
Voluntary isolation and treatment of ill persons.
Asking household members of ill persons to stay at home (quarantine).
Limiting or prohibiting large public gatherings.
Voluntary social distancing.
Communities are important stakeholders in influenza preparedness and response. People should be willing to isolate ill people (voluntarily), limit large public gatherings, and practice social distancing. These measures would limit the spread of the pandemic, if it occurs.
Issues Requiring Further Community-Level Planning
Additional training opportunities between communities and health workers.
Increased communication networks.
Assign designated areas for sick people (Seattle Public Health County, 2006).
Since community-level planning is broad, there needs to be broader efforts to increase communication between community members and health care workers, create additional training opportunities between community members and health care workers, and assign designated areas for sick people.
Interventions for the Department of Housing and Urban Development
Increase house spacing to decrease congestion.
Provide proper drainage in housing projects to improve sanitation.
Improve ventilation in housing projects.
Provide proper waste disposal mechanisms (Steinhardt , 2010).
The Department of Housing and Urban development needs to reduce the incidence of influenza among inhabitants of public housing by increasing house spacing (to decrease congestion), providing proper drainage, improving ventilation, and providing proper waste disposal mechanisms. These measures would improve the living conditions of public housing residents.
General Recommendations
Community mobilization and partnerships.
Culturally specific emergency communications planning.
Culturally specific education and training programs.
Evidence-based measurement and evaluation efforts.
Strategic planning policies.
Inclusion of community members as partners.
Policy and program changes to minimize morbidity and mortality (Holmberg, Layton, Ghneim, Wagener, 2006).
All health, community, and policy stakeholders need to take a proactive approach to prepare and respond to an influenza pandemic. Such measures need to include a concerted effort to create strategic planning policies, introduce policy changes to minimize morbidity and mortality, forge community mobilization and partnerships, and create culturally-specific emergency communication and planning.
Conclusion
The learning outcomes of the paper aimed to educate the public about influenza as a public health concern and formulate culturally competent preparedness and response interventions that address specific needs of public housing residents and low-income population groups.
The paper covered key areas of influenza preparedness including describing the nature of influenza, vulnerable populations, and possible interventions for improving community preparedness.
This paper finds that low income populations and people living in housing projects are vulnerable to pandemic influenza.
There should be a multifaceted approach to prevent influenza.
The multifaceted approach should include communities, policy makers, individuals, and the Department of Public Health.
Preparing and responding to an influenza pandemic requires people to make informed choices regarding how to manage vulnerable populations and how to provide culturally-specific interventions for curbing the pandemic. This paper proposes the introduction of a multifaceted approach for doing so. It should include key stakeholders, such as communities, policy makers, individuals, and the Department of Public Health.
Questions
What is Influenza?
What is the difference between seasonal and pandemic influenza?
What are some recommended strategies for protecting communities against influenza?
How can communities minimize influenza transmission?
These questions aim to enforce the learning outcomes of this paper. They cover important areas of influenza preparedness and management.
References
Armstrong, K., Berlin, M., Schwartz, J. S., Propert, K., Ubel, P. A. (2001). Barriers to influenza immunization in a low-income urban population. Am J Prev Med, 20(1), 21–25.
Blumenshine, P., Reingold, A., Egerter, S., Mockenhaupt, R., Braveman, P., Marks, J. (2008). Pandemic influenza planning in the United States from a health disparities perspective. EmergInfec Dis, 14(5), 709–715.
Bouye, K., Truman, B., Hutchins, S., Richard, R., Brown, C., Guillory, J. (2009). Pandemic Influenza Preparedness and Response Among Public-Housing Residents, Single-Parent Families, and Low-Income Populations. American Journal of Public Health, 99(2), 287-293.
CDC. (2008). Interim guidance on planning for the use of surgical masks and respirators in health care settings during an influenza pandemic. Web.
Compans, R., & Orenstein, W. (2009). Vaccines for Pandemic Influenza. New York, NY: Springer Science & Business Media.
Holmberg, S., Layton, C., Ghneim, G., & Wagener, D. (2006). State plans for containment of pandemic influenza. Emerg Infect Dis, 12(9), 1414–1417.
Krieger, N., Chen, J. T., Rehkopf, D. H., & Subramanian, S. V. (2005). Painting a truer picture of US socioeconomic and racial/ethnic health inequalities: the Public Health Disparities Geocoding Project. Am J Public Health, 95(1), 312–323.
Meltzer, M. (2008). Pandemic influenza, reopening schools, and returning to work. Emerg Infect Dis, 14(3), 509–510.
Osha. (2009). Pandemic Influenza Preparedness and Response Guidance for Healthcare Workers and Healthcare Employers. Web.
Osterholm, M. (2005). Preparing for the next pandemic. N Engl J Med, 352(18), 1839–1842.
Ostrem, M., & Horsburgh, C. R. (2008). Use of a population-based survey to describe the health of Boston public housing residents. Am J Public Health, 98(1), 85–91.
Rocheleau, M. (2013). Boston’s lower-income areas bear brunt of flu. Web.
Seattle Public Health County. (2006). An Influenza Pandemic Planning Guide for Homeless and Housing Service Providers. Web.
Steinhardt , B. (2010). Influenza Pandemic: Greater Agency Accountability Needed to Protect Federal Workers in the Event of a Pandemic: Congressional Testimony. New York, NY: DIANE Publishing.
Stoto, M. A. (2008). Regionalization in local public health systems: variation in rationale, implementation, and impact on public health preparedness. Public Health Rep, 123(4), 441-449.
Additional Reading
Vaughn, E., & Tinker T. (2009). Effective health risk communication about pandemic influenza for vulnerable populations. Am J Public Health, 99(2),324–S332.
World Health Organization. (2008). Pandemic Influenza Preparedness and Mitigation in Refugee and Displaced Populations. Web.
The health of the Black population has been significantly affected by the sequence of recent events and external societal factors. People of color encounter many severe challenges due to the prevalent health disparities and racial inequality (Oni‑Orisan, Mavura, Banda, Thornton, and Sebro, 2021). As a result, communities of color are at higher risk for health challenges, particularly during the spread of coronavirus (Williams, 2018). People of color face health issues, such as increased mental illnesses, substance abuse, diabetes, heart disease, and high blood pressure. Given the risk and complexity of the low state of health among Black people, it is crucial to take immediate steps to combat such disparities and ensure the equal and fair distribution of medical care.
The Current Services
The immense amount of stress and violent behavior of the rest of the population toward Black people increases the risks of mental disorders, provoking depression, anxiety, substance use, and suicide (Taylor and Chatters, 2020). It is also the leading cause of the overall poor physical health of the population in question. Nevertheless, there are many helpful health services designed to help the Black community to address such health issues:
Black Emotional and Mental Health (BEAM): focus on healing, wellness, and liberation of Black people.
The Boris Lawrence Henson Foundation: eliminating stigma and promoting trust for Black communities in the mental health realm.
Therapy for Black Girls: helping Black women to address mental issues through the online platform and finding a therapist in the target area.
Dr. Ebony’s My Therapy Cards: helping women of color grow and develop in the context of emotional and mental health.
Innopsych: changing the role of Black healthcare providers and communities’ perspectives on therapy.
Safe Black Space: focus on dealing with cultural and racial trauma.
As a rule, these health services are funded with the help of federal resources and state and local sources.
The Statistics
The health statistics of the Black population are negatively overwhelming. With one of the largest Black populations worldwide, in the United States, more than sixteen percent of Black people reported mental illnesses over the past year (CDC, 2019). This number constitutes over seven million people of color who struggle with mental disorders. Black people (18-49 years old) are twice more likely to die of heart disease than the white population (Taylor and Chatters, 2020). They are also usually provided with lower-quality medication or therapy than the general part of society. The substance abuse statistics reveal that 6.9% of African Americans deal with a substance use disorder, but they are less prone to alcohol abuse (4.5% of the total population) (SAMHSA, 2018). One in three African-Americans suffers from high blood pressure. People of color encounter severe complications from diabetes, including end-stage renal disease and lower-extremity amputations.
Necessary Measures and Additional Initiatives
To improve the health status of the modern Black community, it is fundamental to raise public awareness and collaboratively work to reduce unequal healthcare approaches to Black people:
Increase access to medical treatment: implement policies for immigrants; extend medical insurance coverage.
Promote social support: form partnerships with community centers to foster Black social mobilization and reduce racial stigma over mental health issues.
Advance current mental health services: regulate federal tax credits for mental health specialists; use financial grants to advance psychiatry programs in rural areas.
Regulate existing policies maintaining structural racism: analyze health data by race and ethnicity at the local and national levels to identify the areas requiring improvement.
Improve Black doctors’ engagement: create culturally sensitive medical care and diversify the clinical personnel.
The initiatives designed to fight the health disparities in black communities should be addressed on the federal, state, and local levels and with the help of private organizations. To track the effectiveness of each measure applied, it is important to test adherence to new practices among the target population and analyze how they affect the delivery of patient-centered care. Stakeholders and volunteers involved must regularly communicate with medical staff and patients to evaluate the level of improvement in patient experience. The data received from the evaluation should give the whole picture of the initiatives’ efficacy.
References
CDC (2019). Summary health statistics: National health interview survey: 2017. Table A-7. Web.
Oni‑Orisan, A., Mavura, Y., Banda, Y., Thornton, T. A., & Sebro, R. (2021). Embracing genetic diversity to improve black health. The New England Journal of Medicine, 384(12), 1163–1167.
SAMHSA (2018). National survey on drug use and health (NSDUH): African Americans. Web.
Taylor, R. J., & Chatters, L. M. (2020). Psychiatric disorders among older Black Americans: Within- and between-group differences. Innovation in Aging, 4(3).
Williams, D. R. (2018). Stress and the mental health of populations of color: Advancing our understanding of race-related stressors. Journal of Health and Social Behavior, 59(4), 466–485.
