Category: Population

Impact on Public Health

The impacts of the COVID-19 pandemic on public health in the US have been large-scale and disastrous. It is yet to summarize all of the effects of the disease in the pandemic aftermath; however, it is already possible to collect some of the subtotals regarding the impacts on public health. Currently, one of the most researched topics is the impact of COVID-19 and other infectious diseases’ outbreaks on the central pillar of the public health system – healthcare professionals. The public health workforce experienced physical and mental health issues and already existing problems with underfunding deepened.

Public health depends on the public health workforce, and the pandemic demonstrated that almost everywhere in the US, the public health workforce was severely understaffed and underfunded. This data is relevant throughout the country and can be generalized to most of the states. For instance, “since 2008, the public health workforce has shrunk by 20%, with 62% of local health departments seeing their budgets flat line, or reduce over time” (Kintziger et al., 2021). Given that, it is no surprise that the pandemic’s new and heavier burden placed on the US public health workforce led to the interruption of essential services and functions provided. This situation resulted from the shift in priorities, activities, and functions of the medical staff across the country – human resources have been transferred to the coronavirus-fighting fronts. As a result, numerous other sectors within general public health have suffered. For instance, in many cases, work on other communicable diseases, foodborne outbreaks, and perinatal diseases were severely interrupted (Kintziger et al., 2021). In terms of general public health, this situation reduced citizens’ access to healthcare services and reduced trust in the sector.

The public health workforce’s physical and mental health is another significant aspect of the pandemic’s impacts. According to numerous studies from all over the globe, public health workers face enormous challenges in terms of mental health issues (Naushad et al., 2019; Preti et al., 2020; Stuijfzand et al., 2020). These included facing post-traumatic, depressive, insomnia, psychiatric, and severe anxiety symptoms. Moreover, more than 30% of healthcare workers who were in direct contact with patients demonstrated long-lasting symptoms of burnout and emotional exhaustion (Preti et al., 2020). As a result, there are issues not only on the individual level but on the broader ones as well. The mental health of healthcare professionals directly influences the quality and quantity of services they provide, affecting the general population’s health creating additional economic and societal costs for communities and nations.

Impact on the Population

Regarding the impacts of the pandemic on the population, in case it is not addressed, the main effect will be on mortality. Currently, due to the efforts of public health institutions across the world, 61.3% of the global population has been vaccinated at least once, which has significantly reduced the potential death toll (Ritchie et al., 2020). If the outbreak had not been addressed, the mortality rate for each country might have been closer to the case fatality rate (CFR), which has varied significantly throughout the pandemic. For instance, according to the study by Hasan et al. (2021), “the weekly global cumulative rCFR of COVID-19 reached a peak at 7.23% during the 17th epidemiological week (April 22–28, 2020).” After that, the rCFR has been declining steadily, achieving 2.2% by December 31, 2020 (Hasan et al., 2021). According to OurWorldInData information (n.d.), it can be argued that the average has been declining further; for instance, it achieved 1.18% in the US by February 4. Unfortunately, there is no data regarding specific cities, states and CFR within those. Despite these numbers, disregard for the COVID-19 outbreak might result in hundreds of thousands of additional deaths in the US alone (Centers for Disease Control and Prevention, 2022).

Emotional distress within the population is also a significant factor of the COVID-19 pandemic that resulted in the increased social costs. There is a general consensus that COVID-19 significantly affects the mental health and well-being of the general population (Fiorillo & Gorwood, 2020; Twenge & Joiner, 2020). For instance, “compared to the 2018 NHIS sample, US adults in April 2020 were eight times more likely to fit criteria for serious mental distress” (Twenge & Joiner, 2020). That is especially severe considering four groups of population: those who have been in contact with the virus; those who are vulnerable to stressors; health professionals; people who follow the news through numerous media channels. If the outbreak is not addressed, it is possible to assume that the rates of mental health issues in society will only grow as the number of infected increases. Moreover, the number of healthcare professionals directly in contact with the infected will also surge. Finally, the social impacts of the pandemic will worsen due to the higher death toll, as the number of people who lost their close ones during the outbreak will subsequently increase as well.

Nursing Interventions and Action Steps

Nursing care was influenced significantly by the pandemic due to its nature as it implies close relationships with the patient. Moreover, COVID-19 created additional risks in everyday nursing practice and, in some cases, increased nurses’ workflow several times. In these difficult conditions, new procedures, measures, and policies had to be implemented to increase the effectiveness and safety of nursing practices, simultaneously shifting priorities while maintaining high service standards. There are various initiatives concerning different parts of the nursing process that facilitate it and help make it safer and more effective in terms of the final goals.

For instance, looking from the human factor perspective, it is vital to ensure adequate protection measures for nurses. These include uninterrupted access to personal protective equipment (PPE), clear infection control protocols, and relevant training (Buheji & Buhaid, 2020). Another case to discuss includes nursing management practices and their role in transforming hospitals into designated hospitals for COVID-19 patients, as this proved to be an effective COVID-19 containment strategy (Wu et al., 2020). The nursing intervention, in that case, included the design and execution of a four-step contingency strategy. Firstly, it implied setting up designated COVID-19 wards; secondly, technical support teams establishment was necessary; thirdly, it was essential to ensure the availability of reserve nurses in the hospital. The final step implied preparing the training plan to meet all of the requirements (Wu et al., 2020).

To establish the wards couple of rooms and buildings were quickly renovated to comply with the relevant regulations and guidelines. “To ensure normal nursing service in all other wards in the hospital, the nursing department requested each department to nominate 1–2 nurses as a COVID-19 ward backup nursing team” (Wu et al., 2020). Some types of training were identified as the critical ones and were provided to all nurses. These included “COVID-19 hospital infection prevention and control, hospital air purification management specifications, medical institution disinfection technical specifications, and personal protection requirements for disinfection and isolation” (Wu et al., 2020). The results of the successful execution of this strategy were exemplary. All patients with COVID-19 were cured and discharged, no one from the showed any symptoms of the infection, and the other departments of the hospital were able to function without disruption (Wu et al., 2020). Therefore, these types of practical nursing interventions with detailed action plan interventions can be employed in other cases as well.

References

Buheji, M., & Buhaid, N. (2020). Nursing human factor during COVID-19 pandemic. International Journal of Nursing Science, 10(1), 12-24. Web.

Centers for Disease Control and Prevention. (2022). Morbidity and Mortality Weekly Report. Web.

Hasan, M.N., Haider, N., Stigler, F.L., Khan, R.A., McCoy, D., Zumla, A., Kock, R.A., & Uddin, M.J. (2021). The global case-fatality rate of COVID-19 has been declining since May 2020. The American Journal of Tropical Medicine and Hygiene, 104(6), 2176-2184. Web.

Kintziger, K.W., Stone, K.W., Jagger, M.A., & Horney, J.A. (2021). The impact of the COVID-19 response on the provision of other public health services in the U.S.: A cross sectional study. PLoS ONE, 16(10). Web.

Naushad, V.A., Bierens, J., Nishan, K.P., Firjeeth, C.P., Mohammad, O.H., Maliyakkal, A.M., Chalihadan, S., & Schreiber, M.D. (2019). A systematic review of the impact of disaster on the mental health of medical responders. Prehospital and Disaster Medicine, 34(6), 632-643. Web.

OurWorldIndata. (n.d.). Case fatality rate of the ongoing COVID-19 pandemic. Web.

Preti, E., Di Mattei, V., Perego, G., Ferrari, F., Mazzettii, M., Taranto, P, Di Pierro, R., Mededdu, F., & Calati, R. (2020). The psychological impact of epidemic and pandemic outbreaks on healthcare workers: Rapid review of the evidence.Current Psychiatry Reports, 22(43). Web.

Ritchie, H., Mathieu, E., Rodes-Guirao, L., Appel, C., Giattino, C., Ortiz-Ospina, E., Hasell, J., Macdonald, B., Beltekian, D., & Roser, M. (2020). Coronavirus pandemic (COVID-19). Our World In Data. Web.

Stuijfzand, S., Deforges, C., Sandoz, V., Sajin, C., Jaques, C., Elmers, J., & Horsch, A. (2020). Psychological impact of an epidemic/pandemic on the mental health of healthcare professionals: A rapid review. BMC Public Health, 20(1230). Web.

Wu, X., Zheng, S., Huang, J., Zheng, Z., Xu, M., & Zhou, Y. (2020). Contingency nursing management in designated hospitals during COVID-19 outbreak. Annals of global health, 86(1), 70. Web.

Introduction

As it has been observed across every place, the population of the elderly has been increasing in the United States due to both social and health issues. As a person ages, new diseases emerge as well as the inability of one taking care of him or herself. Though some people remain healthy up to 100 years of age, due to psychological and physiological issues other people begin showing signs of frailty during the early sixties even in the absence of any serious disease.

This difference has thus caused experts in the field of gerontology fail to describe where specifically the old age begins. As a result, many have proposed the fit for elderly individuals are those people who are aged above the age of 65 years and are either living in homes or under sheltered accommodations. They are healthy and are not receiving any medical prescription as such to support their survival chances.

However, frail elderly are those individuals who are above the age of 65 years old and they are usually dependent on the help from others for their maintenance either at homes or at those institutions that take care of the elderly. Their mobility requires other peoples help and whereas they might not be suffering from diseases such as heart diseases, they require prescriptions for their survival (Woodhouse, Wynne, Baillie, James & Rawlings, 1988). Gerontologists however explain that frailty is not described by the age of the person rather on how healthy they are. Barclay (2008) estimate that 3% to 7% of 65- to 75-year-olds are frail as are about 20% of those older than 80 years while this proportion increases to a third of those aged above the age of 90 years

Barclay (2008) when quoting Linda Fried indicates that

Frailty is a stage of age-related physiologic vulnerability, resulting from impaired homeostatic reserve and a reduced capacity of the organism to withstand stress. It is also characterized as a syndrome that involves a progressive physiologic decline of multiple body systems. Before the age of 75, individuals have efficient reserves to tolerate stressors or to maintain homeostasis. After the age of 75, individuals need compensation around diminishing reserves to preserve function and well being (par 4).

Sociological Issues Faced by the Frail

The sociological issues that the frail elderly faces are many and they include stress and depression fear of death and even change of behavior and personality disorders. It is important to note that any loss is painful: with old age and health problems that come along, the loss of mobility, strength, career and death of someone you love. Whereas grieving over such losses is usually normal, when an individual loses hope and all the joy that makes up life, it changes from normal and translates into stress and depression.

The feeling of isolation and loneliness has been attributed to be a leading cause of stress and depression among the elderly left behind at homes or under the care in the institutions with most of the them either alone at homes or institutions that take care of them, the decreased mobility that comes along and lost privileges, many feel like they have been abandoned or even over relying on others and thus many tend to keep things to themselves leading to sufferings of stress and depression. Other factors that may lead to the increased stress and depression are the health problems, medication, and loss of their beloved ones (Horn& Schaffner, 2003).

The other sociological issue that faces the frail elderly is fear of death. Anxiety and the fear of death is another social problem that faces most of the frail elderly in the society. When death is no longer a distant prospect, many frail elders fear with most of them becoming restless, sweating rapidly and even the blood pressure increases due to the tension. These problems lead to a disturbed relationship between the elderly and those who take care of him or her since when most of them begins behaving in unfriendly manner, the caregiver might become reluctant on offering any help. To contain this problem, the anxiety and fear among the elderly can be reduced by reassuring and using relaxation and comforting techniques (Mackenzie, 2011).

Statistics and Background Data to Document the Issues

Vardigan (2009) indicates that according to a study conducted by National Institute of Mental Health survey it is estimated that

7 depressed in their lifetimes. Another study conducted by the Epidemiologic Catchments Area (ECA), indicates that symptoms of stress and depression were observed in 15% of the elderly above the age of 65% of Americans at the age of 50 or above are currently depressed while 15 % have been (National Institutes of Health Consensus Development Conference Statement, 1991).

As people get older, the chances of stress increasing also get higher and when the stress results in depression, most of these elderly people contemplate committing suicide. This is confirmed by another ECA study also which places depression among the residents over 65 to at 15%, and as a result the elderly account for 25% of suicides per year which are most likely associated with stress (Song, ND). Another study conducted by the Journal of National Cancer Institute indicates that 70% of the elderly suffering from stress and depression are likely to die within 18 months that follow compared to their peers who are not suffering (Vardigan, 2009). This shows the seriousness of stress and depression indicating that care has to be taken when dealing with the frail elderly people

Describe and Discuss the Social – Cultural Factors Contributing To the Issues

The social cultural factors associated with the high rates of stress and depression and the fear of death among the elderly are related to the people these aged people live with. With people growing older, people assume that the symptoms of stress and depression that they show are as a result of old age and not sickness. This makes most of people not concentrate on the health status of the old rather than on their psychological issues leading to increased cases of stress and depression. Sometimes if an elderly person loses his or her memory, many people tend to relate it to old age but it is important to take the elderly to hospital for checkup since they might be suffering from other diseases other than the effects of old age.

The economic factors that lead to depression are due to the fact that the frail elderly need maintenance thus there are costs which are involved. while the children of these old parents go and take employments, they leaves their parents under the care of house helps or institutions that take care of the elderly and thus these old people feel abandoned since there is no one they can relate to and this leads to their feeling that they were abandoned to die at those places not bearing in mind that their children are simply away looking for their upkeep charges.

Identify and Discuss What You Feel Are the Two Most Significant Challenges to Solving the Two Issues

When the behaviors and personality characteristics are lost, the frail elderly portray strange characters such as unfriendliness towards those who are near to them. This works as a hindrance in containing depression since it becomes very hard to communicate with them as they cannot share their problems with anyone and this can cause the problem to persist even to dangerous levels.

Another challenge towards solving the problems associated with the frail elderly is the costs required in order to access the services of a qualified physician. With standards of living rising, many people tend to give minimum care to the elderly as they cannot afford and this does not help at all. As noted by Mackenzie (2011) above.

Propose a Statistical Research Project

I would propose for a statistical research project covering the causes and the solutions of stress and depression among the frail elderly

Plan of the Research Study

I would conduct the research in the city of New York where we would visit the institutions that take care of the elderly as well as homes currently being occupied by the frail elderly. The sample of our study would be of around 500 people from the institutions since it would be easy to interact with them in the different institutions existing within the state of New York. To collect data from the caregivers of the frail elderly staying at homes, a sample of 200 would be enough due to the distance from one home to the other. Random sampling would be conducted in case of an institution while purposive sampling would be conducted for the frail elderly staying at home.

We would then investigate what the common symptoms the frail elderly show when suffering from stress and depression, are they similar or do they vary according to the individual and how the caretakers involved manage these cases and what they would recommend in order to reduce these instances. This would be important as it would give us a closer view of what the elderly as well as their caretakers undergo and how we can rectify the situation to create a comfortable surrounding of our elderly. The data would then be collected in a questionnaire and be analyzed through a likert scale before it is fed to SPSS package for a regression analysis on how factors such as age and loneliness can lead to stress and depression.

After analyzing the data and ensuring there was no bias we would provide the results to Department of Health and Human Services, institutions that take care of the elderly as well as to the families housing the frail elderly to read and understand on the possible causes of stress, signs and how such stresses can be contained before leading to depression which can lead to loss of life.

Reference List

Barclay, L. (2008). Frailty in Elderly Can Be Proactively Managed: An Expert Interview With Renee Roberts, MSN, RN, NP-C. Web.

Horn, C.E., & Schaffner, H.A. Eds. (2003). Work In America: An Encyclopedia Of History, Policy, And Society. ABC-CLIO Publishers.

Mackenzie, M.A (2011). Preparatory Grief in Frail Elderly Individuals. Web.

Melinda, S. (2010). Depression in Older Adults and the Elderly: Recognizing the Signs and Getting Help. Web.

National Institutes of Health Consensus Development Conference Statement: (1991). Diagnosis and Treatment of Depression in Late Life. Web.

Song, G. (Not Dated). Major Depression in the Geriatric Population: A Case Study. Web.

Vardigan, B. (2009). Health after 60: Seniors and Depression. Web.

Woodhouse, K.W., Wynne, H., Baillie, S., James, O.F.W, & Rawlings, M.D. (1988). Who are the frail elderly? Quarterly journal of medicine, New Series 68, No. 255, pp. 505-506.

Introduction

Healthcare is an important aspect of human activity, as well as an integral part of progress. Health outcomes and their distribution within a population are influenced by policies and interventions which become possible due to population health and clinical studies developing them and healthcare administrators applying them. The work of these specialists is as important as ever, yet they must change their practice because of growing disparity of healthcare access, while simultaneously requiring evaluating the potential influence and spending on new healthcare methods and interventions.

Trends Observed and Trends that Should Be Considered

Currently population health outcomes and healthcare service delivery are not in a general crisis. The minor changes of the number of chronic health conditions can be attributed to fluctuating economic development (Hill & Sevak, 2021). However, the trends demonstrate that health disparities among socioeconomic groups grow (Montez et al., 2021). The healthcare system cannot solve the problem because of its social nature, while healthcare providers are often unaware of public health researchers (National Academies of Sciences, Engineering, and Medicine, 2022). Thus, the main problem of population health outcomes is the growing social inequality gap.

The researchers’ complications include finding the balance and cooperation between their respective interventions, while concerning the price and functionality of innovations. Overall, there is a growing need for interdisciplinary research employing methods such as case studies (Montez et al., 2021). An example of such research is an identification of superutilizers of health care by population health researchers and applying interventions developed by clinical research to keep them healthier.

Healthcare administrators must focus on the commercial, political-economic, and legal determinants of health. Promoting exercise and diet could reduce health inequalities if applied with an understanding of the core reasons behind the differential of access (Chin-yee et al., 2018). Healthcare administrators must consider not only the impact that new technologies will have on the overall population’s health, but the potential effects on health inequalities and vulnerable populations as well.

Conclusion

Thus, both scientists and administrators need to change their methods. The reason for this is the inequality of access to medical services. To deal with this problem, it is important to better understand the cost of care and the impact of innovations, to conduct interdisciplinary research, as in the case of superutilizers, as well as promoting exercise and paying attention on the influence of new medical on social problems.

References

Chin-yee, B., Subramanian, S., Verma, A. A., Laupacis, A., & Razak, F. (2018). Emerging trends in clinical research with implications for population health and health policy.The Milbank Quarterly, 96(2), 369–401.

Hill, A., & Sevak, P. (2021). Trends in medical conditions and functioning in the U.S. population, 1997–2017. Disability and Health Journal, 14(2), 101024.

Montez, J. K., Hayward, M. D., & Zajacova, A. (2021). Trends in U.S. population health: the central role of policies, politics, and profits.Journal of Health and Social Behavior, 62(3), 286–301.

National Academies of Sciences, Engineering, and Medicine. (2022). Population health science in the United States: Trends, evidence, and implications for policy: Proceedings of a joint symposium. National Academies Press.

Population

The Salmonella outbreak became a public health concern in the mid-1980s in the Caribbean. In particular, the pathogen caused diarrhea in both the local population and tourists.

One of the most important behavioral determinants is eating raw or undercooked eggs. The odds ratio of the occurrence of the disease, in this case, is the highest among other behavioral practices. Notably that “the implicated food items correlated with the predominance of cases in December and January as many of these foods are consumed more frequently in the holiday season” (Stehr-Green, 2004, p. 9). Living in close proximity to unsanitary farms is also an important social determinant. In particular, the food safety officer identified several farms with unsanitary conditions where Salmonella samples were more common in products. Thus, people who consume eggs from these farms are more susceptible to Salmonella infection (Cardoso et al., 2021). Finally, in a laboratory study of eggs, it was revealed that “Salmonella was detected more often in shell cultures (4.6% of samples) than in content cultures (1.2% of samples)” (Stehr-Green, 2004, p. 10). This aspect identifies that eating eggs with shells or not washing eggs before eating is an important behavioral determinant of infection.

The main disparity regarding the current health issue is the imperfect reporting system in the affected countries. In particular, many healthcare professionals needed additional training for Salmonella detection and laboratory testing. Among the measures to prevent and control the disease, the need to increase the level of education of the population is indicated. Insufficient awareness of the population about the methods of spreading the infection is an important disparity factor. Additionally, not all farms have access to clean water and sufficient sanitation measures. This factor is also of key importance and acts as an aspect of disparity.

The identified determinants are directly related to the defined disparities, as they allow researchers to describe the risk factors for Salmonella infection. In particular, they include insufficient qualification of healthcare professionals in the diagnosis of the disease and an underdeveloped reporting system. One of the most significant factors is the low level of education of the population about the existing risk factors of infection. In particular, behavioral determinants identify that the greatest chance of infection is present in groups that consume raw eggs and pay insufficient attention to washing them. Additionally, the inability to provide sanitary conditions on farms as a disparity factor leads to an increased risk of infection, which is a determinant.

Health Issue

From the study of the population affected by the health issue, it is possible to identify connections between social and behavioral patterns and the conditions for the spread of the infection. In particular, inadequate sanitary conditions, lack of attention to hygiene, low awareness of the problem, and an underdeveloped reporting system contribute to the development of an outbreak. These aspects combined make certain groups at greater risk of Salmonella infection in particular regions. Consideration of the public health issue made it possible to better understand the patterns of the spread of the disease and identify measures to control it. In particular, sanitary conditions on farms, as well as individual behavioral patterns, have been found to be major determinants of the spread of infection. Thus, the Salmonella outbreak is the result of inadequate hygiene and poor sanitation, which is the most significant pattern of infection transmission and outbreaks.

Reference

Cardoso, M. J., Nicolau, A. I., Borda, D., Nielsen, L., Maia, R.L., Møretrø, T., Ferreira, V., Knøchel, S., Langsrud, S., & Teixeira, P. (2021). Salmonella in eggs: From shopping to consumption—A review providing an evidence-based analysis of risk factors. Comprehensive Reviews in Food Science and Food Safety, 20, 2716-2741. Web.

Stehr-Green, J. K. (2004). Salmonella in the Caribbean. Case study.

Introduction

The effects of polypharmacy in the geriatric population have in the recent past increased resulting in more hospital admissions of aged persons and wastage of a lot of resources. This necessitated the Presbyterian Seniorhealth clinic to lead a registered nurse driven SafeMed program, which attempted to reduce the adverse effects of polypharmacy on the aged patients. A group of five members developed a Quality Improvement Evaluation Plan for assessing the effectiveness of the SafeMed program. This paper is anticipated to evaluate the diligence and usefulness of this program evaluation and not the program itself and attempts to research whether procedures were adopted and matters tackled that involved a strong and logical program evaluation (Goedert, 2008).

Logic model

The planners have formulated a very informative and clear logical model on how to go about the program. By aligning work in this manner, planners have a more comfortable way to classify the work and evaluate it. The most significant insights in this model are efforts to measure the outcomes of the program. The logic model is very clear and detailed and presents a clear picture of how the SafeMed program will be implemented. The planners have placed emphasis on the outcomes, particularly the long-term results of the program from their logic model. However, the outcomes in this program can be accomplished through practices autonomous of the program and thus the appraisal of those results would imply program achievement when external factors and outputs influence the results.

Description of the program development

The program description clearly clarifies the SafeMed program’s aim, phase of development, actions, and the capability to improve health. This description also presents a public understanding of SafeMed and what the evaluation is capable or incapable of delivering. The description helps to lay the ground for outlining the program evaluation questions, understanding the focus of its design, and linking program development and appraisal. However, the description is not clear about the resources obtainable to execute the program and fails to present the environmental framework within which SafeMed is to be carried out.

Program history

The history section summarizes the contents of the program by outlining the main issues in the evaluation plan. The program history gives a detailed overview about the evaluation plan. It explains who the planners are and gives an insight about what SafeMed program entails, its benefits, and stakeholders involved. This description assists stakeholders and anyone studying the program to understand the program contents, intentions, and projected outcomes. The planners have also outlined the stakeholders of the program and their roles in developing the program.

Problem program addresses

The program evaluation plan has clearly outlined the problem addressed by the program: the effects of polypharmacy on older people. This section has also provided statistical facts showing the effects of polypharmacy to people age 65 years and above. The problem addressed by SafeMed seems critical to warrant the establishment of a remedial program and thus enhances the significance of the program. The stated problem of SafeMed assists to drive the prospects and to fix the borders for what the evaluation plan is able or unable to deliver. If SafeMed program is successful in resolving this problem, the polypharmacy effects among the older people would decrease thereby cutting the rising costs of hospital admissions and wastage of resources on older persons (Gardella, Cardwell, & Nnadi, 2012).

Target population

The program evaluation plan also provides useful ways of identifying the program’s target population and the stakeholders involved in the program. SafeMed program targets patients aged 65 years and above and who are currently undergoing a series of at least four medications and receiving medical attention at the Presbyterian Senior Health clinic. The choice of older people from the age of 65 years is logical since people who attain this age become more vulnerable to various old-age illnesses and hence subject to polypharmacy. Additionally, the choice of Presbyterian Senior clinic was well advised since the healthcare records a high readmission percentage associated with adverse drugs’ effects on the older people (Hilmer & Gnjidic, 2008). However, the plan does not provide the number of patients that the healthcare attended to, and those that the planners assessed.

Program goals

The program’s goal is well stated in the evaluation plan; bringing down polypharmacy in the older people. The program’s goal is effective in determining the recognition of stakeholders, choice of assessment questions and understanding the right timing of assessment activities. The program’s goal has also assisted in ascertaining the connection between reasons and projected application of the assessment data.

Program Objectives

The objectives of every evaluation plan serve as the benchmark for its success or failure. The planners of the SafeMed program have observed the SMART objective criteria through adhering to the six quality objectives of the Institute of Medicine (IOM). These aims encompass safety, timeliness, patient’s care, effectiveness, competence, and equitable care (Gardella, Cardwell, & Nnadi, 2012). The plan gives specific statements of what SafeMed will achieve in a specific duration. The objectives are also measurable as they answer the questions of what to execute, which activity, when, and how program activities will be carried out. The plan is realistic as it provides concrete things of what the program can accomplish and within the specified six months period. The accuracy objective of the evaluation plan is evidenced by the action of planners to conduct a contentment survey on the program to assess the participants’ views about the program.

Program resources

The planners have revealed the team of experts responsible for executing the program. The planners have stated that the program will be steered by a multidisciplinary team that will encompass one registered nurse, primary care provider, and a pharmacist. The executive leader and quality management controller will oversee the effective delivery of the program. Although the planners have clearly delineated the program resources available to steer the program, they have not provided a clear picture on whether these resources are sufficient and capable of coordinating all the program’s activities and whether the resources will adequately cater for the 50 patients selected (Hilmer & Gnjidic, 2008).

Activities being considered

The activities of the program are organized in a very clear and logical manner. The duties of re-examining, selecting participants, and setting consultation timelines are given to the registered nurse. The pharmacist is accorded the responsibility of conducting monthly telephone consultation to patients and collecting patients’ perceptions about the program. The arrangement of program’s activities reveals the harmony and teamwork of the program facilitators. The program gives the registered nurse the absolute privilege of randomly selecting 50 patients to partake in the program without involving other stakeholders. However, reliance on her decision alone may be misleading, and the plan should have incorporated the pharmacist and an executive leader at the selection stage.

Long term program effects

The program’s long term result is to enhance standards of living through medication observance as confirmed by decreased adverse drugs’ effects, reduced low- density lipoprotein, and blood pressure levels. These long term goals will be a constant guide and a reference to planners in evaluating whether the desired results were achieved. These outcomes will help planners to evaluate the program constantly and remain focused until they achieve this goal (Little & Morley, 2013).

Engaging Stakeholders

The stakeholders for the SafeMed program comprise the pharmacists, patients, family members, health insurance firms, the QIC, and administrative management. The plan has clearly outlined the roles of the various stakeholders involved in the program implementation. For instance, the registered nurses will serve as main resources by monitoring patients’ adherence and providing education to participants (Pervin, 2008). Administrative leaders should ensure that wastage of resources is curbed, and that healthcare services are delivered effectively. However, the plan does not indicate how the various stakeholders will collaborate and how they will execute their mandates without conflicts and collisions with each other. The evaluation plan does not have any mechanisms to assess the stakeholders’ effective understanding and execution of their mandates.

References

Gardella, J. E., Cardwell, T. B., & Nnadi, M. (2012). Improving medication safety with accurate preadmission medication lists and postdischarge education. Joint Commission Journal on Quality and Patient Safety, 38(10), 452-458.

Goedert, J. (2008). Time to roll for SafeMed. Health data management, 16(5), 47.

Hilmer, S. N., & Gnjidic, D. (2008). The effects of polypharmacy in older adults. Clinical Pharmacology & Therapeutics, 85(1), 86-88.

Little, M. O., & Morley, A. (2013). Reducing polypharmacy: Evidence from a simple quality improvement initiative. Journal of the American Medical Directors Association, 14(3), 152-156.

Pervin, L. (2008). Polypharmacy and aging: Is there cause for concern. Accounting Research Network, 25(1), 6-7.

Introduction

Due to the divergences between various ethnic groups, some groups of people tend to be more exposed to some diseases than others. One of the most vulnerable populations out of those living in the US is the Afro-American group. These people have a higher risk of acquiring asthma, heart failure, kidney disease, lung cancer, diabetes, stroke, or unintentional injuries (Johnson, 2015). Not only do these people have worse access to health care but they also frequently are unaware of the dangers that their health conditions may cause. To improve the state of health among African Americans, it is necessary to develop education plans that will include all the necessary information to enhance the at-risk population’s chances of maintaining their health at a high level.

Identifying the Specific At-Risk Population

Afro-Americans have a much higher disposition towards developing diabetes than White Americans due to several reasons. First of all, the representatives of this population group are more prone to obesity which is one of the major causes of diabetes. Secondly, African Americans usually have high blood pressure which is another common cause of diabetes. Thirdly, these people’s level of education and life prevents them from finding out the information about early symptoms of diabetes, as well as its dangers. Thus, this population group faces a 77% higher danger of the disease in comparison with White Americans (Chow, Foster, Gonzalez, & McIver, 2012). Such a combination of social and environmental factors puts African American population at high risk of diabetes.

Evidence-Based Strategies to Improve Health Outcomes for the At-Risk Population Group

Many efforts have been and still are dedicated to the elimination of negative diabetes outcomes for African American population. Several evidence-based strategies have been suggested by the specialists with the aim of increasing the quality of health outcomes for the identified at-risk group.

The first strategy is arranging a patient-centered approach (American Diabetes Association, 2016). Evidence-based practice recommendations are aimed at instructing a general approach to care for diabetes patients. Healthcare workers have to combine their medical experience and science when giving recommendations to patients belonging to a risk group. Not only is the disease itself dangerous but its probable complications bring challenges as well. Thus, patient-centeredness allows clinicians to come up with individual plans of eliminating the risks for each patient.

The second evidence-based strategy in diabetes across the life span (American Diabetes Association, 2016). This approach is concerned with the fact that diabetes is a disease that develops into old age, which means that patients’ conditions should be analyzed at different life periods to obtain the best health outcomes and ways of managing the disease. Due to demographic-associated issues, there is a need to enhance the regulation between clinical approaches while patients move through the phases of their life span.

The third suggested strategy is arranging advocacy campaigns for diabetes patients. People with high risk for disease, such as African Americans, require additional assistance and participation in advocacy projects that are developed to enhance their chances to cope with diabetes (American Diabetes Association, 2016). Such social factors as low physical activity, smoking, and exposure to obesity should be addressed to make the representatives of the at-risk group less likely to meet the most severe challenges of diabetes.

Healthcare Resources that Serve the Vulnerable Population

One of the most effective ways of helping the vulnerable population group is organizing programs for easier access to healthcare services. Such resources may involve state and local financial support for underserved populations. With the help of such measures, the at-risk population group will acquire better access to health care, which will help eliminate the development of diabetes and its negative side effects.

Nursing Interventions that Will Provide Quality Care for At-Risk Population

Taking into consideration the demographic and social characteristics of the vulnerable population, the interventions should be simple and accessible. The easiest to implement is the one that presupposes the use of mobile phone applications (Nundy, Dick, Solomon, & Peek, 2013). One of the most accessible interventions is with the help of text messaging (Nundy et al., 2013). Research has shown that patients who receive text messages helping to monitor diabetes are better at managing their health condition than the ones who do not receive such messages. Another helpful feature is using smartphone applications. Since one of the most frequent causes of diabetes is obesity, an application Fooducate Weight Loss Coach is aimed at relieving this symptom and thus eliminating the possibility of the development of diabetes (“Fooducate weight loss coach,” 2017). With the help of this application, patients can develop healthy eating habits and decrease the risk of obesity. Fooducate Weight Loss Coach suggests information about the nutritional value of food and drink products. Also, with the help of the app, users can analyze the list of ingredients and evaluate the usefulness of the food they consume.

Another kind of interventions is based on the risk group’s religious beliefs. Williams et al. (2013) suggest a faith-based adaptation campaign Fit Body and Soul. The major goal of the program is eliminating obesity. Secondary objectives incorporate leveling blood pressure and raising the quality of life (Williams et al., 2013). The asset of this program is that it presupposes the cooperation of health professionals and church activists, which increases the opportunity of enrolling many representatives of the risk population group.

The third type of interventions addressing the problem of diabetes in African Americans is represented by culturally competent programs (Zeh, Sandhu, Cannaby, & Sturt 2012). Scholars suggest that such interventions are cost-effective and enable a high-quality assessment.

Strategies to Support Plan Implementation

To organize a better implementation of the suggested interventions, the following strategies may be employed:

1. evaluating the education plan: this measure will help to check whether all elements of interventions are possible to be met;
2. creating a vision for carrying out the plan: thinking of the steps that will lead to achieving the objectives of the intervention;
3. arranging a team of specialists that will be responsible for the implementation of the plan;
4. scheduling meetings at which the plan’s success will be discussed.

Conclusion

African American population is vulnerable due to various social and demographic reasons. Due to its vulnerability, this population group has a high disposition towards some dangerous diseases, one of which is diabetes. African Americans have worse access to health care, and they do not have enough knowledge of the disease’s side effects. In order to decrease the negative impact of diabetes of this at-risk population group, several types of interventions are suggested. These programs, if successfully implemented, will eliminate the risks faced by the vulnerable population group and will enable African Americans to lead a normal lifestyle.

References

American Diabetes Association. (2016). Strategies for improving care. Diabetes Care, 39(Suppl. 1), S6-S12.

Chow, E. A., Foster, H., Gonzalez, V., & McIver, L. (2012). The disparate impact of diabetes on racial/ethnic minority populations. Clinical Diabetes, 30(3), 130-133.

Fooducate weight loss coach. (2017). Web.

Johnson, K. (2015). Health is wealth: Five deadly health issues for African Americans.Black Enterprise. Web.

Nundy, S., Dick, J. J., Solomon, M. C., & Peek, M. E. (2013). Developing a behavioral model for mobile phone-based diabetes intervention. Patient Education and Counseling, 90(1), 125-132.

Williams, L. B., Sattin, R. W., Dias, J., Garvin, J. T., Marion, L., Joshua, T., … Narayan, K. M. V. (2013). Design of a cluster-randomized controlled trial of a diabetes prevention program within African-American churches: The fit body and soul study. Contemporary Clinical Trials, 34(2), 336-347.

Zeh, P., Sandhu, H. K., Cannaby, A. M., & Sturt, J. A. (2012). The impact of culturally competent diabetes-related outcomes in ethnic minority groups: A systematic review. Diabetic Medicine, 29(10), 1237-1252.

Infertility is one of the most common problems these days, and it means that a person does not have a chance to get pregnant for several health issues. Many couples in the United States may face this problem, and the causes can vary from congenital diseases to acquired physical or psychological trauma. This body condition does not always affect only females but also males can suffer from this issue. Genetics has a strong influence on infertility, and it may be connected to people of all ages and nationalities. Around 18% of women in the United States between the age of 21 and 52 stated that they had faced infertility in their lives (Mancuso et al., 2020). I believe that environment plays a significant role in this issue. People should be more cautious about their health to predict health problems that may cause the inability to become pregnant or impregnate a partner.

The causes of infertility are diverse and might not be seen by non-professionals. For instance, age plays a significant role as the older males and females are, the more chances of receiving infertility. Moreover, hormones play an important role in pregnancy, and when any type of disbalance appears in the human body, problems with pregnancy might arise. Obesity or anorexia can also indicate infertility as the human body spends crucial resources on other areas to support life without giving a chance for women to become pregnant. Some physiological problems like anomalies of the uterus or ovaries may also become the main cause of the issue.

The percentage of male infertility is not high compared to the opposite gender. Nevertheless, 7% of men suffer from this problem, and the causes of these cases are different (Krausz et al., 2022). Around 20% of those males who cannot impregnate their couples are suffering from genetic factors that were transferred throughout generations. When males check their health conditions and diagnose infertility at early stages, they have a chance to overcome this problem and protect the ability to procreate. Low sperm production may also happen due to psychological factors like depression or any type of disorder.

The percentage of females suffering from infertility is higher, and it is usually related to diseases that cannot be treated. When women become diagnosed with several health issues which do not allow them from becoming pregnant, doctors rarely have a chance to restore the ability to procreate (Barbieri, 2019). Nevertheless, a female’s mentality is under a lot of pressure due to sentimentality, which is specific to this gender, and this factor may cause psychological problems which cause infertility. Abortion might also become the reason for the inability to become pregnant. While the procedure is at the late stages of pregnancy, doctors might not restore the functions that allow women to become pregnant again.

Infertility remains the main problem that is not under full control. In some cases, it may become impossible to give a person a chance to continue becoming pregnant or impregnate their partner. However, sometimes it is possible to solve the problem by using medicines, surgical procedures, and In vitro fertilization (Repping, 2019). Moreover, a psychotherapist can help deal with psychological problems that are barriers to conceiving a child. Every case is unique, and only doctors can decide if any treatment would be useful or not.

References

Barbieri, R. L. (2019). Female infertility. Physiology, Pathophysiology, and Clinical Management, 556-581. Web.

Krausz, C., Rosta, V., and Swerdloff, R. S. (2022). Genetics of male infertility. Perinatal and Reproductive Genetics, 121-147. Web.

Mancuso, A. C., Summers, K. M., and Mengeling, M. A. (2020). Infertility and health-related quality of life in United States women veterans. Journal of Women’s Health, 29(3). Web.

Repping, S. (2019). Evidence-based medicine and infertility treatment. The Lancet, 393(10170), 380-283. Web.

Assessment data was gathered by interviewing a nurse practitioner working at Hope House. The data already gathered is enough to support our work throughout the semester, though it may be important to analyze documented data from the local and state health departments to develop an adequate understanding of the health issues affecting vulnerable populations such as the homeless and women who live in shelters.

Findings from our population-focused assessment indicated that residents of the shelter home suffer from several health issues such as smoking, wounds, COPD, Hepatitis C, diabetes, STDs, HIV/AIDs, and eye problems. Mental health problems and substance abuse were also cited as major health concerns for the residents, who totaled 90 in number (45 men and 45 women with children). Other health issues that arose from the assessment include lack of health insurance, low health literacy levels due to lack of health resources, lack of primary care providers, and lack of nutritional food. Furthermore, the assessment revealed that around 70% of women in the shelter do not know much about the health of their children and lack adequate parenting skills. Yeast and skin infections, toy safety, lack of baby diapers, and lack of a balanced diet formed major health concerns for the children in the shelter. Lastly, several needs of the population residing in the shelter (e.g., toiletries, clothes, backpacks and school supplies) were not being adequately met.

Population-Focused Nursing Diagnosis

The priority nursing diagnoses developed from the assessment findings include (1) knowledge deficit related to little access to women and infant health information and (2) inadequate parenting skills noted in most of the mothers residing in Hope House.

Planning and Evaluating a Population-Focused Intervention

Intervention Plan

• Community Focus Area: Maternal and child health literacy for women residing in the shelter
• Collaborating Organization(s) Group(s): Local health centers, local NGOs, church, public health department, schools, Hope House, child health experts, and nutrition officials

Overall Objective

“Increasing the knowledge on maternal and child health in the shelter with the view to assisting women to make superior health choices and take better care of their children”

Action Steps

Evaluation of Action Plan

Design a plan for how the intervention/project would be evaluated

Problem Statement

Individuals at risk of poor health and healthcare disparities are normally regarded as being vulnerable. For homeless persons and other socially marginalized populations, an effective healthcare system is always not within their reach. Moreover, other social determinants of health, such as income, housing, and social support are often not present. No clear approach to healthcare delivery for homeless persons and other vulnerable people has been defined. Vulnerability, which is likelihood to harm, emanates from an interaction among various factors, including an individual, society, and prevailing life challenges encountered.

Notably, vulnerable people experience extremely high rates of acute and chronic behavioral health disorders and physical conditions and injuries than the general population. Usually, these conditions remain unmet medical needs. Further, competing interests, such as housing and food, implies that vulnerable people may not always prioritize health needs. Most of them are uninsured and often seek care in emergency departments (EDs) when unmanaged symptoms lead to hospitalization.

Project Description and Overall Goal(s)

The practicum, “Improving the Overall Health of Hope House Residents in Middletown, Ohio”, seeks to improve health of homeless individuals. The program will target 40 homeless residents aged between 18 and 75. The overall objective of the project will be to ensure that those who reside in the shelter are encouraged to take care of their own health through access to the necessary knowledge.

This project will be implemented in Hope House Mission, a faith-based shelter for the homeless. Its mission is to provide a wide of range of programs and services designed to achieve long-term, sustainable life transformation for homeless children, men, and women. Homeless persons usually have perceived unmet health needs, and they use high-levels of healthcare, usually in costly emergency departments or acute care settings (O’Toole, Johnson, Aiello, Kane, & Pape, 2016). Thus, the practicum, which is a holistic in approach to public health, will ensure that Hope House Mission and homeless persons have enhanced capacity to address healthcare needs they experience.

Rationale

The practicum is expected to run for about 24 weeks (six months), and will be performed via PowerPoint presentation and following with discussion. Since the facility lacks the equipment to accommodate for the laptops or projectors, I plan on giving each individual a print out of the desired topic being addressed. Having identified the health needs that continue to affect the residents of Hope House, the project leader developed several topics that will be used to improve the overall health of people at the facility.

These topics will aim not only to empower the residents with the knowledge on how to deal with common health issues, but also to underscore the importance of self-worth and self-esteem in managing challenging conditions. Some of the topics that will be addressed in this project are medication management, diabetes and hepatitis C management, self-neglect, oral health management, and vision management. Classes and group discussions will be held on a weekly basis with the residents of the Hope House, who will be encouraged to attend to ensure they gain useful knowledge on how they can deal with common health issues.

Objectives

The objectives of this practicum address multiple areas of public health improvement among homeless persons in Hope House. The objectives include:

1. Increase awareness in homeless people about the significance of overall health and well-being
2. Increase acceptance and usability of effective preventive interventions and treatments in homeless persons at Hope House
3. Promote educational interventions to lessen healthcare problems in homeless shelters
4. Enhance the capacity of homeless shelter programs to offer preventive health services to homeless persons at homeless shelters

These objectives are designed in line with the overall goal of the practicum. Thus, at the end of the practicum, noticeable changes in knowledge, awareness, and practices would be expected in homeless persons at Hope House.

Review

Homeless persons are considered vulnerable, and vulnerability, as previously noted, emanates from multiple sources (Grabovschi, Loignon, & Fortin, 2013; Culo, 2011). For homeless persons, the rate of healthcare challenges are higher compared to the general population (Lin, Bharel, Zhang, O’Connell, & Clark, 2015). For medication management, it is shown that vulnerable people are at greater risks because of limited abilities to manage a complicated medication regimen based on multiple conditions they may experience. Non-adherence to medication, therefore, is a primary contributing factor for poor healthcare outcomes in vulnerable people. As such, interventions, such as education, that help such individuals to manage their medication could assist in avoiding needless, costly emergency department visits, admission, and hospitalization, as well as help in improving quality of life (Knowlton, Nguyen, Robinson, Harrell, & Mitchell, 2015).

Diabetes and hepatitis C virus are two health problems considered as chronic. Studies have demonstrated a significant relationship between diabetes and hepatitis C virus (Ba-Essa, Mobarak, & Al-Daghri, 2016). Notably, patients who share personal items, occupational exposure to blood or its related products, tattooing items, increased transaminases and risk practices were most likely to have both conditions leading to frequencies of hospital admission (Ba-Essa et al., 2016). These results underscore the need for educational intervention for vulnerable persons.

From a broader perspective, self-neglect is a growing condition that is poorly understood social and medical challenge. Self-neglect is a multifactorial behavioral issue that accounts for an individual’s inability or a rejection to attend to own health, personal hygiene, and personal and environmental needs (Culo, 2011).

Self-neglect is the chief reason for “referral to adult protection services” (Culo, 2011, p. 421). In this case, unsafe behaviors expose individuals to self-endangerment, which is an isolated risk factor for death and institutionalization. Vulnerable persons, especially older adults, who demonstrate self-neglect tendencies, usually live in situations of greater isolation, squalor, and foulness. Such individuals may refuse any help because they do not see anything amiss in their conditions.

However, they present safety hazard and health risks to self and others. It is imperative to understand that such cases are controversial and, thus, care providers often argue whether the condition is social or medical, especially when mental conditions are absent (Culo, 2011). In the end, the issue of self-neglect comes to semantics. Nevertheless, individuals who neglect themselves are incapable and sick, and care providers should not ignore them (Culo, 2011). This explains why the practicum will adopt a holistic approach to address overall health and well-being of homeless persons.

Not much is known about the ocular condition of homeless persons (Noel et al., 2015). Visual acuity is significantly associated with reduced overall well-being. Thus, it is a critical educational program for homeless shelters, which host majorities with such complications. The training program will explore factors related to visual impairment and demonstrate the relevance of constant visual screening programs and treatment for homeless persons, especially where free eye clinics are found to help address this unmet health need.

Poor oral health based on all measurement indicators, such as decayed teeth, missing teeth, and oral pain, have been found among homeless persons (Costa et al., 2012). The educational program will cover causes, symptoms, diets, and offer a list of physicians who accept Medicaid and Medicare.

Competencies

This project lies squarely on the public health domain as it aims to protect the safety and improve health of the homeless members of the Hope House community through education. Rather than seeking to provide diagnostic interventions for the health problems affecting the homeless, the project aims to create awareness and empower the homeless on how to manage these issues through education. Additionally, this project is in the public health realm because the feedback received from the intervention could be employed to develop policies and processes in order to ensure the safety and health improvement of the homeless members of the community. Overall, the project’s focus on improving the overall health of Hope House residents makes it a public health issue as the main goal of public health interventions is to safeguard improve health of different community members through education, policy making, and research on disease and injury prevention.

Methods

A holistic approach to public health was used to ensure that the project helps develop all aspects of peoples’ lives that are critical to improving the overall health of the targeted population. The approach was based on the realization that most residents of Hope House face different health challenges and, thus, a holistic perspective was needed to ensure that the project would have an impact on physical, emotional, mental, and spiritual needs of the residents. The justification for using this perspective was due to difficulties to improve the overall health and well-being of the targeted population without adopting such a perspective. The integrated educational package ensured a holistic approach to improve health and well-being of homeless persons while addressing care and underlying health challenges leading to emergency department use (O’Toole et al., 2016).

This practicum containing educational programs prepared by the presenter was presented to homeless persons through face-to-face using oral PowerPoint presentation and brochures. I printed out the copies for each individual participants. The educational interventions happened in a private room, which had a sitting arrangement for about 50 people. These learning materials were kept in a binder to be used as toolkits and references to ensure the continuity of the project even in the absence of the main implementer and for educating new residents. The toolkits contained information and resources to assist the homeless people residing in the shelter in improving their overall health on different levels – physical, emotional, mental, and spiritual.

The project targeted between 35 and 45 homeless individuals at Hope House (note that it was not difficult to find all homeless people at the shelter on a specific day). One general approach to assess learning in the educational package was to administer a pre-test and a post-test examination (Boston University, 2013). The pre-test was administered at the start of the instruction to assess pre-existing knowledge of the content program, including medication management, diabetes and hepatitis C management, self-neglect, oral health management, and vision management. Dr. Jaana Gold (my advisor) and Mrs. Lisa Field (my preceptor) approved the questionnaire before I gave to the residents. Later on at the end of every instruction program involving oral presentations and group discussions, a post-test assessment was administered in an effort to show measurable achievements in homeless persons’ knowledge. The entire practicum lasted 24 weeks (see the table below).

Impact evaluation was used at the end of the interventional educational program to determine the degree to which the practicum met its main goal of knowledge acquisition in homeless persons at Hope House. It was an important instrument to improve the quality of program and improve the outcomes. In this case, pre-test and post-test assignments was used for the practicum evaluation.

Collected data were analyzed using frequencies and percentage to determine changes in knowledge following implementation of the project for homeless persons. Changes in percentage prior to and following the practicum determined potential new knowledge acquired.

Sufficient resources, such as time, funds, instructional materials, and others, were provided to facilitate the implementation of this practicum. The overall interventional educational practicum addressed the following topics: medication management, diabetes and hepatitis C management, self-neglect, oral health management, and vision management within 24 weeks. The topics were divided into different weeks to facilitate the implementation of the practicum through oral PowerPoint presentation, group discussions, pre-tests, post-tests, and brochures to reinforce learning.

Data Analysis

Data analysis involved determining the difference between pre-test scores and post-test scores of homeless men who took part in the integrated educational program to improve their oval health. Analysis was done by examining the change in scores of individual participants to determine if there were any indications of a gain because of education provided. For each participant who took part in both pre-test and post-test, a variation in score (the value of post-test score less the value of pre-test score) for the entire topics covered during the program. This is generally the appropriate way to interpret the impacts of a training program in a given pre-test post-test test, since it allows the researcher to determine the extent of the difference in scores. Scores are displayed in graphic formats and tables for clarity.

Individual improvements of a given point show enhanced thinking (diminished weakness to basic thinking mistakes) and improvements of many points are great confirmation that learners actually benefited incredibly from the training program. These increases in the whole score demonstrate significant changes in learners. The variation in percentile score depends on where the learner’s score is found in the curve. It is imperative to recognize that scores of an individual may drop if the individual is not sure or lacks consistency when they select the best responses for the tasks. However, a drop in scores of many points is normally a characteristic of poor effort at post-test without some other influencing factors, for example, cognitive damage, exhaustion, or testing conditions. Data were analyzed using Excel.

Results

It is important to recognize that the number of participants in who participated in this program in different educational topics were not the same because of homelessness status of participants. For each educational topic, the participants ranged between 35 and 45 (hence, n = 35 – 45). The program was delivered over the course of five months. Only homeless men sheltered at Hope House Residents in Middletown, Ohio and aged between 18 years old and 75 years old took part in this educational program.

For educational program on scabies, the number of participants was 45. Pre-test was administered before the start of the educational program and post-test was also administered at the end of the educational program. The mean score percentage for pre-test was 56.84, and the mean score percentage for post-test was 80.27. Tests administered in the pre-test assessment were the same tests used in the post-test assessment. The mean score percentage difference between pre-test and post-test was 23.43, indicating an improvement of many points, which was a great confirmation that learners actually benefited incredibly from the educational program.

Participants were also tested on diabetes mellitus after the educational program. There were 42 learners who took both pre-test and post-test tests. Pre-test was administered before the start of the educational program and post-test was administered at the end of the educational program. The mean score percentage for pre-test was 66.67 and the mean score percentage for post-test was 84.52. Tests administered in the pre-test assessment were the same tests used in the post-test assessment. The mean score percentage difference between pre-test and post-test was 17.85, indicating an improvement of many points, which was a great confirmation that learners actually benefited incredibly from the educational program.

Learners’ change in knowledge was also tested following educational program on hepatitis C. This class had 35 participants who took both pre-test and post-test tests. Pre-test was administered before the start of the educational program and post-test was administered at the end of the educational program. The mean score percentage for pre-test was 47.8 and the mean score percentage for post-test was 79.06. Tests administered in the pre-test assessment were the same tests used in the post-test assessment. The mean score percentage difference between pre-test and post-test was 31.26, demonstrating an improvement of many points, which was a great confirmation that learners actually benefited incredibly from the educational program.

Learners’ change in knowledge was also tested following educational program on depression. This class had 40 participants who took both pre-test and post-test tests. Pre-test was administered before the start of the educational program and post-test was administered at the end of the educational program. The mean score percentage for pre-test was 56.85 and the mean score percentage for post-test was 78.65. Tests administered in the pre-test assessment were the same tests used in the post-test assessment. The mean score percentage difference between pre-test and post-test was 21.8, demonstrating an improvement of many points, which was a great confirmation that learners actually benefited incredibly from the educational program.

Participants’ change in knowledge was also tested following educational program on anxiety disorder. This class had 45 participants who took both pre-test and post-test tests. Pre-test was administered before the start of the educational program and post-test was administered at the end of the educational program. The mean score percentage for pre-test was 51 and the mean score percentage for post-test was 78. Tests administered in the pre-test assessment were the same tests used in the post-test assessment. The mean score percentage difference between pre-test and post-test was 26, demonstrating an improvement of many points, which was a great confirmation that learners actually benefited incredibly from the educational program.

Participants’ change in knowledge was also tested following educational program on lice. This class had 45 participants who took both pre-test and post-test tests. Pre-test was administered before the start of the educational program and post-test was administered at the end of the educational program. The mean score percentage for pre-test was 60.91 and the mean score percentage for post-test was 93.64 Tests administered in the pre-test assessment were the same tests used in the post-test assessment. The mean score percentage difference between pre-test and post-test was 32.73, demonstrating an improvement of many points, which was a great confirmation that learners actually benefited incredibly from the educational program.

For educational program on nutrition, the number of participants was 45. Pre-test was administered before the start of the educational program and post-test was also administered at the end of the educational program. The mean score percentage for pre-test was 48.04 and the mean score percentage for post-test was 77.02. Tests administered in the pre-test assessment were the same tests used in the post-test assessment. The mean score percentage difference between pre-test and post-test was 28.98, indicating an improvement of many points, which was a great confirmation that learners actually benefited incredibly from the educational program.

Summary of the Results

The above findings demonstrated that participants who took part in the educational program to improve overall health of homeless male at Hope House Residents in Middletown, Ohio did exceptionally well. For educational program on scabies, the mean score percentage for pre-test was 56.84, and the mean score percentage for post-test was 80.27, indicating a percentage gain of 23.43. Test scores for diabetes mellitus showed the mean score percentage for pre-test as 66.67 and the mean score percentage for post-test as 84.52, showing a percentage gain of 17.85. Additionally, for educational program on hepatitis C, the mean score percentage for pre-test was 47.8 and the mean score percentage for post-test was 79.06, which showed a percentage gain of 31.26.

Assessment results for showed that the mean score percentage for pre-test was 56.85 and the mean score percentage for post-test was 78.65, reflecting a knowledge gain of 21.8%. For anxiety disorder, the mean score percentage for pre-test was 51 and the mean score percentage for post-test was 78, depicting an increment in knowledge by 26 percent. The results of the assessment for lice showed that the mean score percentage for pre-test was 60.91 and the mean score percentage for post-test was 93.64, reflecting a change of 32.73 percent. Finally, The mean score percentage for pre-test was 48.04 and the mean score percentage for post-test was 77.02, showing a gain of 28.98 percent in the case of nutrition.

The participants who received this educational program gave overwhelming responses and enjoyed the educational materials left for references and future programs. They were delighted to have these classes and looked forward for more.

Discussion

This project focused on improving the overall health of Hope House Residents in Middletown, Ohio. Its mission was to provide wide-ranging programs and services designed to achieve long-term, sustainable life transformation for homeless men aged between 18 years old and 75 years old. The overall objective of the project was to ensure that men who reside in the shelter were encouraged to take care of their own health through access to the necessary knowledge. A holistic approach to public health was adopted for this educational program.

It should be clear that limited literature is available to provide empirical evidence for health educational programs for homeless individuals. In fact, a more comprehensive work was done in 1994 by May and Evans, and they too observed little report in research specifically for health education targeting homeless persons. Instead, current literature tends to focus on health promotion, which is a wide scope approach for interventions for health education for homeless populations. Nonetheless, the past research determined that healthcare educational programs for the homeless persons in shelters were often delivered by volunteer instructors, such as nurses, who offered lessons on health promotion, disease prevention, and self-care (May & Evans, 1994).

In light of the review of assessment results for a year and a half, it was found that 50 volunteer educators, the greater part of whom were nurses, provided 49 healthcare topics in 176 classes (May & Evans, 1994). Learners showed that the classes were useful, and they expressed their desires for future studies. This research conducted in 2017 still reflects findings established more than two decades ago by May and Evans. It confirms that health educational programs are hardly available to homeless individuals in their shelters, although they always express their desire to have search services.

Homeless is a complex, far-reaching issue in the United States (Coles, Themessl-Huber, & Freeman, 2012). Current health promotion underscores the ideas of lifestyle change, risks, and preventive health behavior, as well as the more extensive societal issues of the environment, public policy, and cultural influences. Therefore, the focus has shifted to a more planned way to deal with health promotion for individuals who are socially excluded, stressing behavioral change by focused interventions at the level of community settings, including homeless shelters.

Research concentrated on homelessness and related health challenges (Costa et al., 2012; Grabovschi, Loignon, & Fortin, 2013; Knowlton et al., 2015), and findings demonstrate the need for urgent action, yet little consideration has been given to the health promotion needs of homeless persons, and there is no clear proof of evidence-based outcomes following interventions. One issue for health promotion is to create and deliver suitable educational activities to a heterogeneous populace that is not generally simple to classify but rather has an extensive variety of health needs. As such, this study settled on a holistic approach to address multiple health concerns of homeless men.

For instance, the healthcare needs of a young fellow without a shelter vary widely from those of an old homeless man with other conditions related to advance age. To be destitute goes beyond a lack of a shelter alone, and it includes other health-related issues among other challenges. Homelessness has as much to do with social exclusion as with housing, and requires a wide range of health promotion methodologies.

Due to lack of earlier interventions and exclusion (Campbell, O’Neill, Gibson, & Thurston, 2015), homeless persons are more probable than other populations to present with a severe illness and regularly utilize accident and emergency units for their healthcare needs. As a result, they are frequently missed by essential care health promotion initiatives.

Usually, healthcare services focused on homeless persons incorporate visiting care providers, community workers, health advocates, and occasional specialists, for example, general practitioners and community nurses, who have given intervention in homeless facilities and day centers (Jego et al., 2016). This study supports a more sustained implementation of educational programs for homeless persons as constituents of health promotion programs. Given these results, health promotion ought to be created with regard to how homeless persons look for care services. As such, this may include significant adjustment of, or specifically a move away from, conventional cases of care delivery, for example, in primary care setting situated in main hospitals.

Many intervention programs aimed for homeless persons have concentrated on illness prevention and are to a great extent not published (Jahan, 2012). These interventions incorporate immunization programs, mobile screening facilities, and the dissemination of condoms, but educational programs are not generally common because of resources (Ba-Essa et al., 2016; Knowlton et al., 2015). Intervention programs also tend to focus on youthful homeless living in the streets, in hostels, or other forms of accommodation facilities. Groups, for example, elderly individuals and families living in temporary settlement have largely been disregarded.

Even in this study, the focus was only on male, leaving out female homeless persons irrespective of their needs. Homeless care services are frequently engaged in emergency services provision and, thus, the long-term care of homeless persons is not generally a priority. Undoubtedly, health may not be a need for homeless persons themselves. Rather, basic survival needs, for example, food, water, and shelter may occupy their thoughts more than the likelihood of diseases. Hence, one valuable intervention may just be to inform such an individual where the closest shelter offering food and drink is. Thus, health promotion ought to likewise give useful help, for example, food, drink, and clothing. In the meantime, information can also be given about how to avoid some health risks and improve general hygiene.

The main objective of the homeless health educational program is usually to offer health information to homeless people and families in an unmistakable, precise, socially acceptable way to advance understanding, involvement, motivation, empowerment, and constructive health behavior change. This aim is successfully realized by applying different techniques drawn from the areas of health education and social or community work.

Engaging homeless persons is extremely important to service delivery because offering specific health information and supportive solution can only take place when individuals have expressed their concerns openly to care providers. Once educational programs have been provided, it is imperative to explore the recommendations and implement them. For instance, shelter providers should now strive to improve the provision of health information by organizing many formal educational and interventional classes and individually focused sessions on health subjects or topics important to needs of specific groups.

Health instructors give training and support around a wide scope of themes, for example, hypertension, nutrition, asthma, diabetes, hepatitis, HIV/AIDS, condom use, pregnancy, tuberculosis, physical activity, cancer, tumor, smoking, alcohol abuse and other substance abuse, oral health, and stress management, to give some examples. This demand for health educational programs demonstrates a complex system that requires a holistic approach.

This study was based on the formal needs of homeless persons at Hope House Residents in Middletown, Ohio. Irrespective of the lack of published findings, there are cases of specific issues that healthcare promoters consider great practice. These strategies account for national campaigns designed to meet local health needs, health fairs and other group based health promotion events, and outreach programs specifically designed for homeless persons. Strategies relying on peer interventions, concentrating on counselling and rapport building have also been effective. Many experts have now established services to cater for health needs of homeless individuals.

Training materials, especially those concentrating on chronic disease, such as HIV and AIDS information tend to target young homeless people while other health information on diabetes, heart conditions, obesity and others are have been targeted for older homeless persons (Culo, 2011; O’Toole et al., 2016). This demonstrates attempts to reach specific segments of homeless individuals. Health promoters have additionally focused on the significance of practical solutions.

As such, instructing homeless individuals about dental care might be inconsequential simply because they a toothbrush and toothpaste, and care for personal hygiene may not generally be practical for individuals sleeping in the streets. Thus, straightforward, practical help may occasionally be the most suitable type of health promotion. Health promotion efforts, therefore, should be accompanied by some quick and practical solutions. For instance, homeless alcohol and drug abusers might be more amiable to general health promotion activities once they are some forms therapies.

It is also important to recognize that health promotion efforts targeting homeless individuals may not record the best success rates (Jahan, 2012). This implies that multiple barriers are faced before homeless individuals can receive the intended health promotion initiatives. These barriers have been linked to multiple issues. First, health educational initiatives or educators are often isolated. As such, little collaboration or coordination is noted between stakeholders. In fact, it is recommended that any interventions targeting homeless individuals should be an integrated, multidisciplinary approach (Maness & Khan, 2014).

Second, public health departments have largely ignored health promotion and education for homeless persons. Third, some health promotion materials are written in technical languages, which usually need high levels of literacy or specialized knowledge. Hence, homeless persons feel excluded by such materials. Finally, while homeless persons may eagerly seek care, low self-esteem and diminished expectations often inhibit them from involving health promotion initiatives.

Some challenges are more complex. Numerous organizations do not have the capacity to implement health promotion without support. An essential factor is to gather the right resources and workforce, and design a framework for health promotion (Jahan, 2012). Health promotion also faces vested interests of various stakeholders. Powerful entities, such as businesses, are most likely to influence health promotional outcomes, for instance.

There is an increasing acknowledgment of part of ethics and, thus, stakeholders are expected to emphasize the practical reasons and benefits for health promotion. Educational programs are the best interventions engage homeless persons to determine what they value and how they can embrace practical approaches to reduce health risks and management existing conditions. To accomplish this goal, particular interventions to local circumstances are required as opposed to treating all groups similarly. Another issue is to develop a long-term rapport with marginalized individuals, such as homeless persons.

As poverty and inequality escalate in society, homeless persons and other disadvantaged groups may fail to appreciate any messages associated with health promotion. It will require some efforts, time to stakeholders offering related services, and find the right homeless persons. More importantly, this study revealed that homeless persons in different setting require different approaches. As such, the study strives to enhance access to health care for marginalized, underserved persons in society, and this should be a matter of public health policy. There are difficulties identified with research in the field of health promotion, specifically for health education for homeless persons (Jahan, 2012).

There is absence of implementation evidence in health promotion practice and absence of use of evidence while developing promotional strategies. There are specialized challenges in assessment of health promotional strategies. For performing assessment of health promotion outcomes, it is essential to characterize and gauge the results of the intervention, as was done in this case. Suitable approaches for assessment of intervention outcomes should be developed and embraced. To enhance the quality of studies in the health educational programs, researchers and other stakeholders should enhance the quality and number of published works, specifically for homeless persons and other marginalized groups.

Despite these drawbacks, health promotions have positively influenced health care outcomes in both private settings and public health initiatives (Jahan, 2012). Various public health accomplishments are credited to health promotion. Some of the most incredible health promotion accomplishments of include immunization; more secure work environments; infectious disease control; diminished mortality rates associated with chronic conditions; safer and more beneficial diets; family arranging and enhanced maternal and child health; fluoridation of drinking water and fortification of some foodstuff; and acknowledgment of health risks associated with tobacco use.

None of these accomplishments would have been conceivable without health promotion (Jahan, 2012). In these examples, clearly, specific achievements associated with homelessness are not defined. Nonetheless, health promotion is a necessary intervention strategy, and empowers individuals to adopt practical solutions to their health needs. Health promotion should be implemented in a team with individuals and requires their committed involvement. It assists communities in enhancing their capacities and their skills to take activities, which promote healthy living. They act in groups to bringing about change and improve outcomes.

While challenges exist for health promotion initiatives, opportunities have also been identified for the same (Jahan, 2012). Various agencies, organizations, and individuals around the globe are focused on health promotion for their communities. World organizations, such as the World Health Organization (WHO) and others, continuously highlight the plight of homeless individuals as among the most vulnerable in society. As such, they respond by developing strategies, projects, and activities designed for health promotion. Any health care related visits for different reasons for existing are open doors for wellbeing advancement exercises.

It is particularly critical for homeless individuals who may face difficulties gaining access to care facilities. As such, when they are visited at their shelters, the visits should be used to advance health among the most vulnerable population. Visits for any purpose are an opportunity for health promotion to enhance health outcomes of the target groups. Although immense opportunities for promoting health can be found the existence of current advanced technology and electronic modes of communication, these tools are largely not accessible to homeless persons. Nonetheless, health educators can exploit them to deliver their topics.

As previously noted, it is important that any health promotion initiative ought to be implemented following an evaluation of health needs of the target group. This strategy will not just help distinguish needs but will help with planning and creating interventions as indicated by the needs of the target group and different settings.

The difference of specific groups of homeless persons is clear. In comparison with general health promotion efforts, directed interventions can concentrate on the specific needs of homeless groups, for example, persons without shelter, single parents, adolescent, women, or seniors. It is imperative to conduct further research to determine the key health promotion needs of various homeless groups. Identification of informal communities, networks and the engagement of homeless persons in developmental assessments will identify the places and best methods for delivering health promotion. In this study, the researcher had to identify the best venue to reach homeless persons with health educational promotional program.

That is, it is extremely difficult to offer any interventions for homeless persons without prior planning. Social networks and peer educators, and sources of food and drinks can significantly contribute in health promotion for homeless persons. It all requires any creative strategies, which require careful implementation and assessment. Education appears to be the best initial strategy for homeless persons, who lack basic knowledge on self-care.

The numerous needs of homeless individuals force them into contact with many different support organizations. However, the response of a given organization is frequently narrowly focused and determined by emerging cases, rather than long-term approaches. Yet, the different qualities of these multiagency facilities introduce a genuine chance for collaborative health promotion. For instance, health educators can work with shelter home operators to deliver educational programs to homeless individuals, for instance. These organizations can ensure long-term health promotion for homeless persons by coordinating with relevant stakeholders. Novel primary care stakeholders may offer a perfect discussion to establish procedures, supported by sufficient resources to improve interventions. Shelter services may well take part in health promotion to ensure that many homeless persons are reached during their stay.

Recommendations

Results from this study showed that participants who received this educational program gave overwhelming responses and enjoyed the educational materials left for references and future programs. They were delighted to have these classes and looked forward for more. However, from the discussion, it was established that limited literature is available on health education for homeless persons. Much literature tends to concentrate on multiple health issues homeless persons face, but do not look at educational interventions. As such, researchers should focus on impacts of health education programs targeted at homeless persons as a constituent of health promotion to enhance general health.

Research ought to show that health education programs are important for improving health among homeless persons. It is also shown that delivery and promotion for homeless persons require coordination. Hence, researchers should also work together. There is additionally a need to promote collaboration among all stakeholders.

The health promotion initiatives ought to be research based and target specific groups, for instance, vulnerable men. It is important to appreciate the role of evidence in health care settings. Hence, failure to publish findings on health promotion programs is a major drawback to stakeholders who rely findings to make recommendations on policies. In fact, only one old source, in this case, was directly linked to the subject under homeless health education.

The study shows that health care professionals play a major role in health care promotion among underserved populations. Hence, adaptation to clinical practice ensures that health care professionals play a critical part regarding treatment and education of patients and in promoting enhanced health care outcomes within vulnerable groups. Findings provide a practical basis for implementing policies that support physician engagement for the medically marginalized, underserved homeless persons. Improving the health outcomes of homeless individuals is an important initiative to reduce cases of morbidity and mortality in society. General practitioners, family physicians, and nurses are preferably appropriate to offer care, all-inclusive, and sustained care for homeless patients and to guide multidisciplinary teams.

Strengths and Limitations

Given the limited research on health education programs for homeless persons, this research was extremely useful. The learning was conducted in a normal setting (shelter for homeless persons) and, thus, the results were reliable and not prone to any external influences. It might not be possible to generalize the findings of this study to other homeless facilities because only descriptive statistics was used. It was not always easier to find all participants and, thus, their number kept on fluctuating for every topic across the four months of the study.

Conclusion

The aim of this health educational program was to improve overall health of homeless male at Hope House Residents in Middletown, Ohio. The educational program was implemented for four months using a holistic approach. The results showed an exceptional performance in knowledge gain among participants. The participants who received this educational program gave overwhelming responses and enjoyed the educational materials left for references and future programs. They were delighted to have these classes and looked forward for more. Across the seven areas evaluated, results were excellent demonstrated the desire among homeless persons to learn. As such, these results will enable the development of a new model of primary care for health education programs to improve access to healthcare for underserved homeless individuals.

Health care professionals and researchers could effectively advance to the improvement of health care and outcomes for homeless persons, if homeless shelters and other stakeholders can coordinate their efforts. It is necessary to establish a group of multidisciplinary to support vulnerable people in society.

While outcomes were positive and participants were delighted, limited works exist on outcomes of education programs targeting homeless persons. As such, it was difficult to find current empirical data to support the findings of this study. This study therefore recommended further studies in health care educational programs specifically targeting homeless persons.

References

Ba-Essa, E. M., Mobarak, E. I., & Al-Daghri, N. M. (2016). Hepatitis C virus infection among patients with diabetes mellitus in Dammam, Saudi Arabia. BMC Health Services Research, 16, 313. Web.

Boston University. (2013). Choosing the right assessment method: Pre-test/post-test evaluation. Web.

Campbell, D. J., O’Neill, B. G., Gibson, K., & Thurston, W. E. (2015). Primary healthcare needs and barriers to care among Calgary’s homeless populations. BMC Family Practice, 16, 139. Web.

Coles, E., Themessl-Huber, M., & Freeman, R. (2012). Investigating community-based health and health promotion for homeless people: A mixed methods review. Health Education Research, 27(4), 624-644. Web.

Costa, S. M., Martins, C. C., de Lourdes, C. B., Zina, L. G., Paiva, S. M., Pordeus, I. A., & Abreu, M. H. (2012). A systematic review of socioeconomic indicators and dental caries in adults. International Journal of Environmental Research and Public Health, 9(10), 3540–3574. Web.

Culo, S. (2011). Risk assessment and intervention for vulnerable older adults. British Columbia Medical Journal, 53(8), 421-425.

Grabovschi, C., Loignon, C., & Fortin, M. (2013). Mapping the concept of vulnerability related to health care disparities: A scoping review. BMC Health Services Research, 13, 94. Web.

Jahan, S. (2012). Health promotion: Opportunities and challenges. Journal of Health Education Research & Development, 1, e105. Web.

Jego, M., Grassineau, D., Balique, H., Loundou, A., Sambuc, R., Daguzan, A.,… Gentile, S. (2016). Improving access and continuity of care for homeless people: How could general practitioners effectively contribute? Results from a mixed study. BMJ Open, 6(11), e013610. Web.

Knowlton, A. R., Nguyen, T. Q., Robinson, A. C., Harrell, P. T., & Mitchell, M. M. (2015). Pain symptoms associated with opioid use among vulnerable persons with HIV: An exploratory study with implications for palliative care and opioid abuse prevention. Journal of Palliative Care, 31(4), 228–233.

Lin, W.-C., Bharel, M., Zhang, J., O’Connell, E., & Clark, R. E. (2015). Frequent emergency department visits and hospitalizations among homeless people with Medicaid: Implications for Medicaid expansion. American Journal of Public Health, 105(S5), S716-S722. Web.

Maness, D. L., & Khan, M. (2014). Care of the homeless: An overview. American Family Physician, 89(8), 634-640.

May, K. M., & Evans, G. G. (1994). Health education for homeless populations. Journal of Community Health Nursing, 11(4), 229-37. Web.

Noel, C. W., Fung, H., Srivastava, R., Lebovic, G., Hwang, S. W., Berger, A., & Lichter, M. (2015). Visual impairment and unmet eye care needs among homeless adults in a Canadian City. JAMA Ophthalmology, 133(4), 455-460. Web.

O’Toole, T. P., Johnson, E. E., Aiello, R., Kane, V., & Pape, L. (2016). Tailoring care to vulnerable populations by incorporating social determinants of health: The Veterans health administration’s “homeless patient aligned care team” program. Preventing Chronic Disease, 13, E44. Web.

Many people suffer from chronic diseases, which is a common phenomenon nowadays. Chronic illnesses can vary from diabetes to asthma and significantly impact a person’s everyday life. Regularly individuals are unaware of having any kind of chronic disease, and they spend a decent time of their lives without knowing about it. However, some population groups are affected more than others to the particular health problems. The race or ethnicity minorities of the population may be at the higher explosion to the different chronic diseases due to numerous factors such as genetics or discrimination. Therefore, this paper aims to evaluate the black population of New York state affected by hypertension and analyze the reasons behind it and the interventions to improve the health outcomes.

One of the high-risk groups most affected by chronic high blood pressure is African Americans. Hypertension was initially a widespread issue all over the United States, but the black population has the highest rates of dealing with the illness. They can get hypertension at a young age, especially those children who also suffer from obesity. However, specific risk factors exist that influence the appearance and the development of hypertension and might cause complications of the physical state. Regarding sex, men are the ones who tend to get hypertension more often than women. At the elderly age, both female and male individuals tend to be at a higher risk, especially if they smoke, lead an inactive lifestyle, and overuse alcohol (Mills et al., 2020). In addition, more narrow-focused factors such as pregnancy, family history disease, or second type o diabetes may result in high blood pressure.

Besides all the fundamental characteristics, the black population experience additional causes of hypertension, which make them a high-risk segment. Its reasons may consist of the genetic features and their socioeconomics position in society. Considering their biological background, black people tend to be overweight and have sensory blood vessels (High blood pressure and African Americans, 2022). Nevertheless, socioeconomic reasons are the most influential in this case and intensify already existing conditions. Black population compared to the white live in the greater stress resulting from the difficulties of getting a well-paid job, existing in poverty, and having a household in the dangerous criminal districts (Clark et al., 2019). Therefore, African Americans have fewer opportunities to get a quality education, lead a healthy lifestyle, and access medical care and information (Howard et al., 2018). Moreover, because of all the factors, many black people are unaware of having the disease or its danger to their health, and as a result, they do not take any measures.

In the different regions of the United States, indicators of hypertension prevalence vary significantly. New York state’s counties illustrate the distinction between the counties. Many African Americans live in the Monroe and Westchester counties, and Monroe county portrays a greater level of hypertension prevalence among the black population than Westchester, resulting in the indicator differences. The crucial social determinants such as quality of life, income, and unemployment determine the outcome of the prevalence in the two compared areas. Monroe county has higher adult smoking and obesity indexes than Westchester (New York, 2022). It also shows a higher percentage of excessive drinking and fewer possibilities for physical activity, resulting in a poor physiological state (New York, 2022). In addition, Westchester demonstrates noticeably lower statics regarding the socioeconomic factors, and its unemployment rate is less than Monroe’s (New York, 2022). Children who live in a poor household in Westchester represent 10% of the population which is almost two times lower than Monroe county (New York, 2022). Thus, some social determinants lead to disparities in the health conditions of the black communities.

In order to improve the situation with the healthcare and decrease the negative outcomes for the group at high risk, several decisions were implemented. Firstly, the initial cause of this is racial discrimination, limited access to medical resources, and crisis in public health. Consequently, the primary focus should be on the social and cultural factors in the first place. One of the efficient approaches is to spread awareness among the community and educate black people about the issue.

Several electronic and online services help people get information on health issues, particularly hypertension. For instance, websites such as the website Medicare.gov allow individuals to easily find healthcare institutions near their homes and choose from those who provide more affordable services and consultations (Find and Compare Nursing Homes, Hospitals and Other Providers Near You, 2022). Nurses are also the ones who contribute to the spread of health literacy by informing the patients about the diagnosis, causes, and treatment (Loan et al., 2018). Those who work in schools can promote knowledge among the children and teenagers, which positively affect their lives and prevent them from negative outcomes. Another way that helps to improve the medical care regarding hypertension is the cooperation with the community partners, particularly those involved in the healthcare (Ferdinand et al., 2020). Their investment and work regarding technologies and health promotion among community cities such as supermarkets or barbershops reduce the risk factor.

Overall, the black population is more affected by hypertension than the white due to some biological but mainly social factors such as poverty, lack of education, and unemployment. Racial discrimination is a huge factor that puts African Americans at high risk and exposes them to chronic disease. However, with the help of informational electronic sources and the cooperation inside of the community by providing access and the knowledge about the high blood pressure helps to lower the number of risk factors.

References

Clark, D., Colantonio, L. D., Min, Y. I., Hall, M. E., Zhao, H., Mentz, R. J.,… & Muntner, P. (2019). Population-attributable risk for cardiovascular disease associated with hypertension in black adults. JAMA cardiology, 4(12), 1194-1202.

Ferdinand, D. P., Nedunchezhian, S., & Ferdinand, K. C. (2020). Hypertension in African Americans: advances in community outreach and public health approaches.Progress in cardiovascular diseases, 63(1), 40-45. Web.

Find and Compare Nursing Homes, Hospitals and Other Providers Near You. Medicare.gov. Web.

High blood pressure and African Americans. Stanford Children’s Health. Web.

Howard, G., Cushman, M., Moy, C. S., Oparil, S., Muntner, P., Lackland, D. T.,… & Howard, V. J. (2018). Association of clinical and social factors with excess hypertension risk in black compared with white US adults. Jama, 320(13), 1338-1348.

Loan, L. A., Parnell, T. A., Stichler, J. F., Boyle, D. K., Allen, P., VanFosson, C. A., & Barton, A. J. (2018). Call for action: Nurses must play a critical role to enhance health literacy. Nursing Outlook, 66(1), 97-100.

Mills, K. T., Stefanescu, A., & He, J. (2020). The global epidemiology of hypertension. Nature Reviews Nephrology, 16(4), 223-237.

New York. County Health Rankings & Roadmaps. Web.