A large percentage of the residents in the United States are individuals from racial and ethnic minorities living in poor conditions and are uninsured. These are high-risk individuals that experience several difficulties because they have poor access to health care resources and facilities. Information regarding proper healthcare practices is not easily accessible by the group making them at risk. In order to provide assistance to this group, it is important to analyze various public health nursing determinants and resources that can be used to provide assistance. This paper involves an analysis of the community and public health nursing, social determinants of health, epidemiological data, and a nursing diagnosis with a health plan for the family of case study one.
Case Study
The family under the case study is a nuclear family that lives in a low-income and high-crime area. The father is the main decision-maker and controls most of the finances. He is unemployed, smokes a pack of cigarettes, and suffers from depression after suffering from an accident at work. The mother is seven months pregnant and has several health conditions such as obesity, diabetes, hypertension, and PTSD after witnessing the murder of her father. She is passive with her relationship with her husband after she went through continual physical abuse. They have two sons where the first son has a poorly controlled asthma while the second son has asthma and development delays. The general nature of the family can be considered as poor since they have limited resources. They have little income that comes from the disability of their father and they receive food stamps and welfare from their two children. They have limited income and they eat unhealthily and have limited time to dedicate to leisure and resourceful activities.
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Public health nursing and community partnerships can play a significant role in the improvement of the health outcomes for different individuals. The community identified was that of case study one of a family that lives in a high-risk community. Flores (2017) identified several methods that can be used to improve community partnerships to improve health outcomes in high-risk communities. The first step involves identifying communities that have the highest proportion of low-income minority and families that have uninsured children. While the children have medical coverage, they rarely go to the hospital due to the distance involved. Other forms of assistance could involve hiring staff responsible for data collection and community engagement, implementing a mentor program that should create jobs, and engaging community partners in the health issues of the community.
Influence of Social Determinants of Health
Social determinants of health include several key domains that can be used to improve health outcomes. The Health Plan 2020 identifies the key domains as such as economic stability, education, health care, neighborhood and environment, and social and cultural context (“Explore Resources Related to the Social Determinants of Health”, 2019). In order to create effective programs, there should be a collaborative approach across the different sectors to address the unique needs of the community. For the community selected in case study one, the cultural context can be used to enable the provision of resources. Health information and knowledge can be passed to the community based on the cultural context. This will enable understanding of health information within the group.
Epidemiological Data Analysis
Epidemiological data is available through windshield surveys, census data, and interviews in the state and local department. The data would provide a better analysis of the health challenges and other problems facing the community. For the given case, epidemiological data on the state of Georgia shows that chronic diseases such as heart disease, diabetes, cancer, stroke, and chronic respiratory are one of the leading causes of death. Obesity was ranked as one of the leading health concerns where 30.2% of non-institutionalized adults were defined as Obese in 2013 (“Burden of Chronic Disease in Georgia”, 2015). The data would be a reflection of the community chosen for the case study which shows that the mother has had issues with obesity and diabetes. The father is a chain smoker and is at high risk of contracting a chronic disease like cancer.
Community Diagnosis
The nursing diagnosis for the given community would be that of the mother. The diagnosis is that the family is deficient of knowledge regarding resources and has a lack of exposure about follow-through health instructions. From case study one, the mother is obese, seven months pregnant without prenatal care, has an uncontrolled type two diabetes and hypertension, and PTSD. She has shown a general lack of knowledge regarding the need to have prenatal care to have a successful delivery. The family also lacks limited resources and cannot get their children to the hospital frequently.
Healthy People 2020 Leading Health Indicator Goals and Analysis
The leading health indicators based on Healthy People 2020 would involve maternal, infant, and child health. The objective of the health indicator is to improve the well-being of mothers, infants, and children. This can be addressed by improving several conditions such as health system indicators, quality of life affecting families and communities, and health behaviors (“Maternal Infant and Child Health”, 2019). Maternal, infant, and child health are of critical importance because it can be used to determine the health and well-being of the next generation.
Nursing Interventions
The nursing intervention to be used for the diagnosis regarding the lack of knowledge will involve teaching of the community and family regarding the importance and measures to ensure the improvement of health behaviors. A public mass outreach can be undertaken for the entire community to ensure that they are sensitized. Through the help of a nurse, the family can undertake lessons regarding specific factors of their health.
Health Partnerships
Health partnerships established within the community can be used to improve the health conditions of the family. This will enable health information regarding healthy behaviors to reach the community. Health partnerships can improve the processes of monitoring and raising awareness regarding the identified health problems for the given group.
Nursing Plan
The nursing plan involves the setting of goals, a planned action, needed resources, and evaluation timeline for a sustained community change. The main goal of the nursing plan will involve getting prenatal care for the mother and having the kids to receive medical attention. The second goal will involve having the father manage his anger and alcohol abuse issues. The planned action will involve getting the mother to be covered by insurance and get prenatal care. A worker can try to find ways for the children to get transportation for the children and the father can be assigned to a counselor. The required resources to facilitate the plan will involve proper healthcare practices to be undertaken regardless of the family’s financial situation. The evaluation for a sustained change will be undertaken on a monthly basis for the father and children while the mother should go for prenatal care on a fortnight basis.
Conclusion
The role of the community and public health nursing involves identifying the health needs of the community and resources that can help families like that of the case study one. Epidemiological data should aid in determining the specific nursing needs and concerns for the community. Healthy People 2020 can be used to determine the diagnosis and develop the right interventions for the community. For the given case study, the diagnosis was that of a lack of knowledge and the health indicator involved maternal, infant, and childcare. The intervention would involve teaching the community and health partnerships to monitor and raise awareness regarding the pertinent issues.
References
Burden of Chronic Disease in Georgia. (2015). Retrieved from https://dph.georgia.gov/sites/dph.georgia.gov/files/Chronic%20Disease%20Burden_Rana_8.13.15.pdf
Explore Resources Related to the Social Determinants of Health. (2019). Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-health/interventions-resources
Flores, G., Walker, C., Lin, H., Lee, M., Fierro, M., Henry, M., ... & Massey, K. (2017). An innovative methodological approach to building successful community partnerships for improving insurance coverage, health, and health care in high-risk communities. Progress in community health partnerships: research, education, and action , 11 (2), 203-213.
Maternal Infant and Child Health. (2019). Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/maternal-infant-and-child-health
