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Advocacy Letter

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Submitted By Viviennechew
Words 1102
Pages 5
Mei Chew
Professor Casprowitz
SCN 195/7752
January 14, 2012
Advocacy Letter
Dear Dr. Thomas A. Farley, Commissioner, Department of Health and Mental Hygiene,
My name is Mei Chew and I am a Nursing student at LaGuardia Community College. I am currently taking Community Health course whereby we have an assignment to look into the health issues in our neighborhood. In examining the Community Health Profiles, Second Edition-2006, from New York City Department of Health and Mental Hygiene, I noticed one major concern in my neighborhood that I would like to offer suggestions on.
As we know, New York City is made up of 42 different neighborhoods. Since I reside in Flushing, Queens, the community I belong to is North Queens. According to the Community Health Profile, the population of North Queens in year 2000 was 255,500. Residents of North Queens are slightly older than other parts of Queens and New York City overall. Those in the age range of 45-64 years is 24% in North Queens compared to 22% in Queens and 21% in NYC, and those age 65 and older is 16% in North Queens compared to 13% in Queens and 12% in NYC. In terms of education, this community has higher percentage of college graduates (28%) than Queens (24%) and NYC overall (27%). North Queens has much higher proportion of white (43%) and Asian (35%) residents than Queens (white 33%, Asian 17%) and NYC overall (white 35%, Asian 10%). The percent of residents living below poverty level in this community is 13%, which is lower than Queens (15%) and NYC overall (21%). Half of the residents in North Queens were born outside of the U.S. The foreign born rate in North Queens (50%) is higher than Queens (46%) and NYC overall (36%).
According to the Take Care New York report, one out of three residents in North Queens has no health insurance and one out of five residents do not have a regular doctor. North Queens ranked below average in Take Care New York Goal number 7, “Get Checked for Cancer”. Women in North Queens are less likely to get regular Pap tests for cervical cancer than women in NYC overall (70% vs. 80%), and their rate of getting mammograms for breast cancer is 74% which is at least 11% lower than Take Care New York target rate. In addition, only 42% of adults aged 50 and older in North Queens have had a colonoscopy in the past 10 years, which means more than half of these men have not had the screening. The highest cancer-related death rates among men in North Queens are due to lung cancer (38%) and colon cancer (18%). Among women, lung cancer (23%) and breast cancer (20%) are the main causes of cancer-related death. This coincides with a higher percentage of smokers (20% of adults) in North Queens compared to Queens (16%) and NYC overall (18%). Besides screening for cancer, North Queens residents are less likely to have been tested for HIV (15%) than those in NYC overall (23%). It is highly alarming that 44% of positive HIV test results are in late diagnoses (already progressed to AIDS) in this community.
As a primary intervention, adopting specific lifestyle behaviors and getting vaccinated can lower the risk of getting cancer. Lifestyle behaviors include avoiding tobacco product and secondhand smoke, minimizing alcohol intake, following a balanced diet, exercising regularly, and practicing safe sex. Raising awareness about the impact people can have on their health status through adopting healthy lifestyles is a step towards cancer prevention. In addition, vaccination, such as HPV immunization, can reduce the risk of cervical cancer; therefore, women should be encouraged to do so. We can spread the information via advertisements on television and radio, passing out flyers on the streets and putting up posters or other kinds of advertisements around the community. These advertisements need to be in different languages since there are many non-English speaking residents in North Queens. Lung cancer, for example, develops from smoking. I suggest that the government impose a ban on smoking in all public places, including bars, hotels and casinos, and not just part of the premises. Since many smokers usually start in their early teens, we need to teach school children that smoking is not “cool” and that secondhand smoke is detrimental for their health.
Cancer screening represents an important component of secondary intervention. Many residents in North Queens did not get tested or screened for cancer due to several reasons. Some residents do not have access to health insurance. Although the elderly and disabled may have Medicare and those poorer residents can get Medicaid, many others cannot afford the high cost of health insurance premium. There are a multitude of Asian and Hispanic residents in North Queens who are deprived from health care due to their illegal status. Therefore, I suggest that free or low cost screening be offered to all residents regardless of their legal status. Those who have health insurance may simply be unaware of its availability. There is a large community of middle aged residents who are not aware of the importance of getting screened for cancers such as colon (colonoscopy), breast (mammogram) and cervical (Pap smear) because they have not received the information that targets them personally. Some people are afraid of pain or have fear of finding out the results. These residents need to be educated and encouraged, and be reminded that getting tested can save lives. I suggest that volunteer programs be implemented that will raise more awareness in our community. It would be extremely helpful to have mobile vans be distributed around the neighborhood with volunteers speaking different languages to help give out information, encourage and assist residents with cancer screening. For those who seldom leave their house, television and radio advertising may reach this type of residents. Home health visits can be conducted to focus on bringing the importance of cancer screenings. When the residents received targeted information, it may catch their attention and will want to make regular doctor visits.
Depending on what type of cancer and the severity, tertiary intervention will include surgery to remove the tumors, radiation therapy, and chemotherapy. For lung cancer, quitting smoking is necessary. Nicotine patches can be given out to help quit smoking. Having a support group is imperative at this stage. Again, I suggest that low cost insurance or governmental assistance be available to help patients cover the medical costs.
I appreciate your attention to my letter and I hope my ideas will be helpful with your efforts. Sincerely,

Mei Chew

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