Culture of Health, Essex County and Newark City

Identified Issue and Rationale 

The primary health behaviors raising major concerns in Essex County include adult smoking, adult obesity, food environmental, exercise opportunities, and excessive drinking. Others include STI’s and teen births (Izzo, 2019). Essex County ranks highly on the adult smoking rate at 17 percent and with the highest within New Jersey at 14 percent. However, the County’s health care sector helped push through the Tobacco 21 laws to tackle emerging smoking among the youth. The legislation took effect this year, and the county officials are optimistic that it will help address the high smoking rate in the County. The law requires that those purchasing cigarettes are above the age of 21 years. At the same time, the County’s Chlamydia rate is high and still climbing. From early 2019, the County has numerous new cases that have increased to 130 from 109 (County Health Rankings, 2019).  

Newark City’s vision on health is anchored on a place where people are healthy and live long lives. The city is committed to identifying, evaluating, and researching on health issues to improve health prospects of the locals. The state is also committed to increasing public awareness on comprehending the primary determinants of disability, disease, and health. It also strives to measure the objectives and goals applicable to the people’s level and state. As at the end of 2018, Newark earned a rating of 4.5 out of 5.0 meaning that the state earned a top rating and stood at number #18 out of all the US states ( Mangano & Sherman, 2019) . 

Newark City in New Jersey is dragging behind on the number of persons covered by insurance. Only about 23 percent are covered. All are under the age of 65. The city’s Department of Health and Community Wellness is committed to offering health accessibility, environmental, and social services to its locals. The city has six units that cover the health and hygiene aspects of the town. They include Vital Statistics, Women, infants, and Children, immunization, health education, and community engagement, and emergency preparedness. The city is also committed to counter communicable infections through its infectious disease unit. Other vital services include homeless services, medical care services, the division of Ryan White HIV/AIDS, and health planning, division ( Mangano & Sherman, 2019) . The health planning division is committed to researching, data collection, analyses, and support of all health initiatives in the city. 

Essex and Newark occupy a sensitive place in terms of health care due to their aggressive push and strategies put in place by their respective County’s Public Health sector. The department is committed to upholding and using relevant health programs to support safe health practices and related policies. The country has a young population that, if not educated on health concerns, may succumb to drug use, especially smoking. At the same time, rising cases of obesity are putting the lives of older adults at risk with the high cost of health concerns among families. The County’s focus on partnering with independent bodies, agencies, and organizations play a vital role in highlighting the local's health needs (Izzo, 2019). Not only has health concerns been an outspoken issue in Essex and Newark but it also remains one of the most discussed social aspects of the communities in the regions.   

Ranking (County/National) 

In the past decade, Essex County has continued to improve on health issues, and it remains one of the highest-ranked in New Jersey. In County Health Ranking and Roadmaps, Essex County was ranked 17 out of 21 with the quality of life at 19 (County Health Rankings, 2019). The County moved 27 slots in the national health ranking. The County Health Ranking and Roadmaps, point out that the leading indicators included adult’s obesity, STI’s, alcoholism, driving impaired deaths, and child mortality. The report focused on the country’s health care services and socio-economic aspects that included poverty levels, school graduation, air pollution, violent crime, and the natural physical environment. The ranking takes into account the strong relationship Essex has with other agencies and organizations over the last decade.  

In Newark, University Hospital rated poorly due to numerous problems associated with the hospital staff, nurses, doctors, surgery, and new infections. In fact, due to the poor rating, hospitals such as United Hospital Medical Center, and Mount Carmel Guild hospital have been closed in the recent past due to poor service delivery and poor rating. Only Newark Berth Israel Medical Center rated highly with an A in New Jersey’s hospital rating. The Hospital has excellent trauma services in the city. The Columbus Hospital LTACH ranks highly on acute medical treatment with diverse health programs for the locals. The Hospital took an aggressive approach to help locals learn more about water lead contamination in 2016. Together with the city’s administration, the hospital staff helped supply bottled water to residents to reduce the widespread use of contaminated water. 

Social Determinants 

The main social determinants of health in Essex County include; people’s behavior, social environment, and the physical environment. Others include social support initiatives such as those put in place by the county health department. Gender also is a sole determinant as older men in the county are prone to excessive drinking and smoking. With an increased number of youths engaging in smoking and sexual encounters, beliefs and community response to social issues is a strong determinant of health. In Newark, the main social determinants include the social environment, social programs, and public health initiatives. The water crisis brought forth a new challenge to the city but has been used as a strong determinant in health-related issues. 

What the County Is Doing to Address the Situation 

According to Linda Beers, the County Health Director, Essex County has embarked on a county-wide awareness effort to enhance physical activity and healthy food to residents. The director stated that the health sector is working in conjunction with the Mayor’s office to ensure that residents have health equal opportunities and that health disparities are addressed adequately. Essex has worked with bodies to spearhead initiatives such as “Creating Healthy Schools and Communities” and “Well Fed Essex County.” The programs, according to the report, are earmarked to address health disparities and inequalities in the health sector. The city is working closely with community-based organizations to highlight on the health risks of using contaminated water, urging residents to use bottled water. On the other hand, Newark’s progress has been fronted by University Hospital, Newark Beth Israel Medical Center, and Saint Michael’s Medical Center. 

Newark, on the other hand, has taken an aggressive measure on clean water, which has been a risk factor. The University Hospital, together with Newark Berth Medical Center, has been at the forefront in educating locals on the need to use clean water to avoid lead contamination. Newark Network Department of Health and Community Wellness, together with the Retail Food Establishment, has established high standards of the public’s health activities. The inspections carried out are aimed at keeping the city’s health standards high and within the recommended level. 

Who Is Working on The Problem? 

The county health director is spearheading various health initiatives to address the Essex’s health needs. The office of the count director is working closely with the office of the mayor, schools, and private health care facilities and independent organizations to address the health challenges noted in Essex (Izzo, 2019). The health department is also working closely with legislators to pass necessary laws to curb unhealthy habits such as smoking. The passage of the Tobacco 21 bill is a clear indicator of the Essex’s commitment to engage with relevant authorities to address emerging health concerns. In Newark City, Newark Health Inspection is working closely with local agencies, hospitals, and private health facilities to maintain high health standards. Education and learning institutions are also at the forefront of ensuring that locals are well-informed of the expected health standards in the city.   

Strategies in Use 

The main plans include physical activity for the residents, increased access to healthy food, the passage of and relevant legislation such as the Tobacco 21 laws ( Izzo, 2019) . At the same time, the health county director’s office has initiated various health programs to address health needs, such programs are aimed at reducing health disparities. They include institutions such as the University of Wisconsin Population Health Institute and Robert Wood Johnson Foundation ( Izzo, 2019) . In Newark city, University Hospital EMS (UH-EMS) has the largest EMS system in the nation. In addition to an active medical staff, the city has in place a capable medical staff all round for the locals to use. 

Measure to Evaluate Outcome 

Just like measurements of other healthcare outcomes, County’s health director uses various strategies of quantifying the outcomes. The measurement is aimed at improving healthcare, enhancing healthcare timeliness, and lowering the cost of services (World Health Organization, 2016). Measuring results is critical to help understand and evaluate the general healthcare setting in addition to putting in place initiatives that can rectify any wrongs and drawbacks. At the same time, measurements and outcomes help in quantifying the strategies in place.  

Essex County and Newark City will mainly use timeliness, readmission, and patient experience, the safety of care, readmission, and mortality. Newark focuses more on safety of care and mortality to measure the health outcome. For Essex, the primary health concerns of the County are smoking among old, sexual infections, obesity, exercise opportunities, and excessive drinking. Newark however, focuses more on clean drinking water that is its main concern. Thus, measuring outcomes will determine patient experience for obesity patients, the effectiveness of care for addicted smokers, readmission for obese patients, and the safety of care for sexual infections. For example, readmission will mainly quantify the rate of admission. The estimation will also be measured in costs incurred by patients and the relative reduction rate of their admission.  

Patient experience will determine perception of general health following an admission, care, or diagnosis. The information is critical in enabling a quick response to outstanding issues. For example, on a scale of 1 to 5, a patient will be asked how he or she rates their experience during particular care.  

Robert Wood Johnson Culture of Health 

Robert Wood Johnson Culture of Health is built around working with others in which everybody has the chance to live healthy. According to Tait, Wójcik, Plough and Lumpkin, (2018) t he framework of the organization's culture of health is in collaboration with RAND Corporation and has the strategy of well-being, equity, and health concerns. The agenda identifies various factors that build on multiple ways to create a philosophy of health. To achieve its objectives, the organization recognizes the numerous challenges and shifts its values towards getting a healthy nation and people. It is seen in Essex and Newark cities where efforts of improving health are seen with provision of Medicaid and insurance covers (Atkind, 2014). Tait et al., (2018) maintain that the philosophy is aimed at guiding all aspects of work, helping it focus on the initiatives and research to evaluate the efficiency of the outlined programs. The organization works in close collaboration with other bodies to better the health of all in the communities. Essex and Newark are seeking the framework they will adopt to solve the health problem (Robert Wood Johnson Foundation, 2019). Health initiatives, for example, in Newark to create awareness against HIV/AIDS and how the problem can be controlled. Some of the initiatives to address health problems include immunization, health education, and community engagement. 

Conclusion 

Essex County is mainly concerned with the high rate of smoking among older adults. Other significant concerns include obesity among the aged, exercise activity, sexually transmitted diseases, and excessive drinking. Newark, on the other hand, is concerned about high rates of HIV/AIDS. The county directors of health are responsive to significant concerns and ha in place strategic initiatives to address them. There are different initiatives implemented in the two counties aimed at improving overall health. Other programs such as affordable health and insurance are aimed at enhancing access of quality care among people in Essex and Newark. 

References 

Atkind, M. I. (2014). Supporting ACA/Medicaid Expansion Enrollment in Essex County, New Jersey.  Policy .  https://www.gih.org/files/FileDownloads/ACA-Medicaid_Expansion_Enrollment_HFNJ_September_2014.pdf   

County Health Rankings. (2019). Rankings: Essex (ES). Retrieved October 27, 2019, from https://www.countyhealthrankings.org/app/new-jersey/2019/rankings/essex/county/outcomes/overall/snapshot . 

Izzo, E. (2019, April 23). Essex County health ranked among top 10 in state. Retrieved October 26, 2019, from  https://www.suncommunitynews.com/articles/the-sun/essex-county-health-ranked-among-top-10-in-state/ . 

Mangano, J., & Sherman, J. (2019). Increases in Mortality for All Causes and All Cancers Combined before and after Startup of a Nuclear Power Plant in New Jersey, USA.  Journal of Environmental Protection ,  10 , 488-499. 

Robert Wood Johnson Foundation. (2019, September 24). Building a Culture of Health. Retrieved October 29, 2019, from https://www.rwjf.org/en/cultureofhealth.html. 

Tait, M. E., Wójcik, O. P., Plough, A. L., & Lumpkin, J. R. (2018). Building a Culture of Health in Our Changing Climate. https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2018.304361 

World Health Organization. (2016).  Health system efficiency: How to make measurement matter for policy and management . World Health Organization. Regional Office for Europe.