Concepts in Community and Public Health

Question 1 

Social determinants of health are the factors that influence the health status of a person through interactions and influences and could be either positive or negative depending on how the individual’s relationship is to the conditions (Ferrer, 2018). One of the factors is socioeconomic factors. In this case, individuals with a poor economy and negative social relations are more prone to developing a disease in that the low financial status prevents them from seeking medical services in the appropriate times. Also, there is an educational factor. This leads to disease development in individuals with lower educational levels since the majority have a negative attitude and negligence towards seeking medical services. Environmental factor entails the internal and external environment. This factor covers both personal and environmental hygiene (Wick et al., 2020). An example of this is poor waste disposal which may result in diseases like cholera. Another factor is healthcare access which may be undermined due to lack of insurance covers and high health costs. This results in the poor being denied proper medical services, thus contributing to disease development.

The contagious disease chain model represents the interactions between the infectious agent, then the environment, and the susceptible host and how this interaction eventually leads to disease. However, there are several steps undertaken to break the chain. These steps are carrying out immunizations and vaccinations, education on environmental hygiene, ensuring proper waste disposal, promoting healthy nutrition, and maintaining a safe water supply (William, 2020).

Question 2 

One of the most common global health issues is mental health. It is a state of well-being where a person notices their capabilities, cope with the normal stress of life, and contribute to the community (Prince et al., 2007). This global issue has various impacts on public health. These impacts include social isolation due to poor mental health. This usually disrupts a person’s freedom of communication and interaction with others. It also leads to financial and emotional strains to the involved families as they struggle to seek treatment for the member affected. Mental problems also potentiate the development of physical illness (Maier et al., 2010). With the ongoing COVID-19 pandemic, health care workers may be prone to developing mental health issues (Khanal et al., 2020). This will directly impact the public healthcare system as there will be an inadequate labor force.

Health care delivery systems work in collaboration to deal with mental health in various ways. One of them is the creation of public awareness and sensitization on mental health. This ensures that people are made aware of factors that may result in mental health. These factors include drug abuse, and thus, society is sensitized to the dangers of these drugs. Also, this system ensures the provision of education on all the concepts of mental health to the public. This ensures that all mental health patients are treated in the right manner with proper care, thus promoting their quick recovery. This system ensures empowerment to the involved individuals rather than shame and being honest on the treatment measures to the families and individuals (Stuijfzand et al., 2020).

Question 3 

Vulnerable populations are individuals or groups who are more prone to poverty, diseases, and social exclusion than the rest of the population. This includes the elderly population (Shi et al., 2021). This group is considered vulnerable since they experience a higher cost of healthcare which exceeds their income. Also, this group is prone to poverty because they cannot raise adequate funds to earn a living. This is due to their deteriorating energy and ability to work. They also have poor access to health services. This results in mental and physical health. However, due to old age, they experience social exclusion and isolation, making them vulnerable (Khullar & Chokshi, 2018).

These individuals cannot advocate for themselves since they have inadequate information on the complex programs available for them, illiteracy, and low education levels. This makes it hard to express themselves. Also, poor mental status, reasoning, and disenfranchisement make it hard for them to air out their issues. Thus, promoting their marginalization. Ethical issues to be addressed include accountability and transparency from people responsible for handling their funds. This will ensure they receive proper care thus, promoting good health and economic status (Nies & McEwen, 2018).

Question 4 

Ways of recognizing bias, stereotypes, and implicit bias within the community include noticing one’s assumption toward clients, understanding the impact of the assumption in an individual, and understanding cultural differences between a client and a patient (Marcelin et al., 2019). Various ways have been put in place to address the concept. This includes having a basic and prior understanding of the culture from which a client comes. Also, seeing people as individuals and not a group that is promoting individualized care helps promote equality. There is also a need to concentrate on the magnitude of unconscious bias and use various methods to de-bias the patient, such as education and teach-back techniques (Sukhera & Watling, 2018). Finally, through early and prompt recognition of situations that amplifies stereotyping and bias.

Strategies to reduce cultural dissonance and bias include personal awareness of the implicit bias via training. Also, focusing on the individuals, not a group, provides an understanding of the individuals' cultural beliefs and behavior and how to handle them appropriately. Finally, focusing on cultural practices and belief ensures understanding of one's culture, which enhances diversity to promote the acquisition of diverse knowledge of different cultural beliefs (Slobodin et al., 2020).

Question 5 

The US does not have a universal healthcare delivery system. Instead, multiple subsystems have been developed. On the evaluation of the delivery system, it is a barrier to universal health coverage. It is high on the cost to most individuals. There is biasness in access to health services as the services provided in each subsystem are different, and the health outcome according to the structures is just average (Barr, 2016).

The US healthcare financing system is not centralized in that individuals may pay directly for the services through insurance cover. On evaluation, there are many differences in the range of services covered thus, affecting the access and health outcome (Singh, 2015). Health care reform for improving the system's effectiveness is adopting universal health coverage for delivery and financing. This is because it helps minimize the cost, promotes equability in access and utilization of the services, thus improving the quality of health outcomes. In addition, this reform would enable the government to have fewer expenditures on medical services (Bravata et al., 2005).

Question 6 

Part 1

The passing of the Patient Protection and Affordable Care Act has positively impacted health care policy in the US. The act aids in strengthening the health care system in America. (Gable, 2011). The act has promoted the expansion of access to insurance cover. This has enabled individuals to have their insurance cover. Also, the act states that employers need to cover their workers, thus promoting a healthy workforce. The act increases consumer insurance protection and emphasizes prevention and wellness by providing capital for disease screening and mass immunization (Edmonds et al., 2017).

Part 2

The act is responsible for curbing rising health costs by providing more oversight of health insurance premiums and practices emphasizing prevention, primary care, and effective management of chronic illnesses. The role of a nurse in implementing this law ranges from education role. This includes providing all the information to the individuals involved, both the pros and cons of the act, advocating for individuals experiencing fraud to case finder which is achieved during the conducted screening programs, and case manager during the screening programs (Rosenbaum, 2011).

Question 7 

For manmade disasters, a community can experience distrust amongst the members in their faith and future. As a result, chaos and misunderstanding may occur among them and may result in more loss of lives and damages to the property (Brenner et al., 2010). At an individual level, hopelessness and negativity occur depending on the severity and magnitude of the destruction that arises from the disaster. For the health care professional, feeling of a somber mood, grief, and astonishment while viewing wounds and trauma of the individuals involved predispose them to seek spiritual and moral support to bring back their strong belief and protection (Clark et al., 2019).

A community health nurse can help in the spiritual care of people and the society. They can achieve this by identifying and assessing the individuals and community opinions regarding the particular concept. Thus, promoting understanding and acceptable individualized and personalized care hastens the healing and recovery process (Cain & Barthelemy, 2008).

Question 8 

Ensuring optimal behavior and making sure more lives are saved in a crisis has forced health care facilities to adopt some prevention measures. Among the primary prevention measures include ensuring required equipment for medical and surgical procedures are available, for example, medications and intravenous fluids that would assist individuals in recovering from more serious injuries (Schweizer &Renn, 2019). Secondary prevention entails conducting mass immunization for all individuals with wounds and trauma, especially the tetanus toxoid vaccine as per the guidelines and administration of broad-spectrum antibiotics to the injured individuals to prevent complications such as sepsis (Rickard et al., 2020). This falls in the second phase as it prevents further complications associated with sepsis and open wounds. There is also tertiary prevention. This involves the evacuation of the individuals from the scene (Mashi et al., 2019). This falls in the reconstructive phase as it helps the individuals acquire more energy and retain their health to survive and reconstruct their community. However, the agencies I would work with are American Red Cross and FEMA since these are global organizations working to reduce the impacts of natural disasters. Thus, they can appropriately help in facilitating the activities.

References 

Barr, D. A. (2016). Introduction to US health policy: The organization, financing, and delivery of health care in America . Johns Hopkins University Press .

Bravata, D. M., McDonald, K. M., Shojania, K. G., Sundaram, V., & Owens, D. K. (2005). Challenges in systematic reviews: synthesis of topics related to the delivery, organization, and financing of health care. Annals of internal medicine, 142(12_Part_2), 1056-1065.

Brenner, G. H., Bush, D. H., & Moses, J. (Eds.). (2010). Creating spiritual and psychological resilience: Integrating care in disaster relief work. Taylor & Francis .

Cain, D. S., & Barthelemy, J. (2008). Tangible and spiritual relief after the storm: The religious community responds to Katrina . Journal of Social Service Research , 34(3), 29-42.

Clark, P. Y., Joseph, D. M., & Humphreys, J. (2019). Cultural, psychological, and spiritual dimensions of palliative care in humanitarian crises. A Field Manual for Palliative Care in Humanitarian Crises , 1-160.

Edmonds, J. K., Campbell, L. A., & Gilder, R. E. (2017). Public health nursing practice in the Affordable Care Act era: A national survey. Public Health Nursing , 34(1), 50-58.

Ferrer, R. L. (2018). Social determinants of health. In  Chronic Illness Care  (pp. 435-449). Springer, Cham. 

Gable, L. (2011). The Patient Protection and Affordable Care Act, public health, and the elusive target of human rights.

Khanal, P., Devkota, N., Dahal, M., Paudel, K., & Joshi, D. (2020). Mental health impacts among health workers during COVID-19 in a low resource setting: a cross-sectional survey from Nepal.  Globalization and health ,  16 (1), 1-12. 

Khullar, D., & Chokshi, D. A. (2018). Health, income, & poverty: Where we are & what could help.  Health Affairs ,  10 . 

Maier, T., Schmidt, M., & Mueller, J. (2010). Mental health and healthcare utilization in adult asylum seekers. Swiss medical weekly, 140, w13110.

Marcelin, J. R., Siraj, D. S., Victor, R., Kotadia, S., & Maldonado, Y. A. (2019). The impact of unconscious bias in healthcare: how to recognize and mitigate it.  The Journal of infectious diseases ,  220 (Supplement_2), S62-S73. 

Mashi, S. A., Oghenejabor, O. D., & Inkani, A. I. (2019). Disaster risks and management policies and practices in Nigeria: A critical appraisal of the National Emergency Management Agency Act.  International Journal of disaster risk reduction ,  33 , 253-265. 

Nies, M. A., & McEwen, M. (2018).  Community/public health nursing-E-book: promoting the health of populations . Elsevier Health Sciences. 

Prince, M., Patel, V., Saxena, S., Maj, M., Maselko, J., Phillips, M. R., & Rahman, A. (2007). No health without mental health. The Lancet , 370(9590), 859-877

Rickard, J., Beilman, G., Forrester, J., Sawyer, R., Stephen, A., Weiser, T. G., & Valenzuela, J. (2020). Surgical infections in low-and middle-income countries: a global assessment of the burden and management needs.  Surgical infections ,  21 (6), 478-494. 

Rosenbaum, S. (2011). Realigning the social order: the Patient Protection and Affordable Care Act and the US health insurance system. J. Health & Biomedical L., 7, 1.

Schweizer, P. J., & Renn, O. (2019). Governance of systemic risks for disaster prevention and mitigation. Disaster prevention and management: an international journal. 

Shi, Leiyu, and Gregory D. Stevens.  Vulnerable populations in the United States . John Wiley & Sons, 2021. 

Singh, D. A. (2015). Essentials of the US health care system. Jones & Bartlett Publishers. 

Slobodin, O., Clempert, N., Kula, Y., & Cohen, O. (2020). Educating health professionals for cultural competence in emergency situations: A study protocol for a randomized controlled trial.  Journal of advanced nursing ,  76 (1), 380-386. 

Stuijfzand, S., Deforges, C., Sandoz, V., Sajin, C. T., 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(1), 1-18.

Sukhera, J., & Watling, C. (2018). A framework for integrating implicit bias recognition into health professions education.  Academic Medicine ,  93 (1), 35-40. 

Wick, J. Y. (2020). Social Determinants of Health: How environmental factors affect health.  The Senior care pharmacist ,  35 (2), 56-67. 

Williams, T. (2020). Breaking the chain of infection. Journal of Perioperative Practice, 30(4), 83–84. https://doi.org/10.1177/1750458920914256