...and the Robert Wood Johnson Foundation, among others, recognize that health disparities in diabetes result from complex interactions of individuals with social, political, and environmental factors (1). Therefore, interventions designed to reduce these disparities and improve health care for African-Americans and Latinos with diabetes must also intervene at multiple levels. That same research also indicates that optimal disease management for patients with diabetes should include mechanisms for screening and managing depression. An article in the International Journal of Psychiatry in Medicine reports that in a group of diabetes patients who were screened for depression, the majority (56%) of the sample screened positive for depression (PHQ-9 >10), and half (49%) did not have evidence of that diagnosis in their encounter data. The study further concluded that the prevalence of co-morbid disease in diabetics may be as high as from 30% up to 50%.(2) Patients with diabetes are twice as likely to experience depression as those without diabetes. While diabetic patients who are also depressed show an increased incidence of diabetic complications, screening for depression in diabetics is not routine.(3) Moreover, patients with diabetes who have co-morbid depression have decreased medication adherence, poorer adherence to exercise and diet, and poor glycemic control,(4) Diabetics with depression have total health care expenditures that are 4.5 times more than for those who are not...
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...1. What health disparities are faced by the populations served by your clinical site? a. According to The Dartmouth Atlas of Health Care (2014), blacks with diabetes in Chicago had 1.7 times the rate of limb amputations than whites with diabetes. This can be attributed to several factors including lack of physical activity due to fear of crime infested community, inability to pay for medication, and deficient knowledge of “healthy” food choices. 2. How does the clinical site address the disparities? What resources are present? a. At Fantus Clinic they provide a pharmacy in which patients can receive their diabetic medicine at a discounted rate; they furthermore have a nutrition program that counsels diabetic patients on how to select healthy food choices when grocery shopping. 3. Are the methods used to address the health disparities representative of evidence-based practice? Explain why or why not? (Cite references) a. The interventions used at Fantus follow evidence based guidelines due to the fact they coincide with strategies suggested in The Chronic Care Model. In this model community health organizations are required to teach patients how to self manage their chronic which is exactly what Fantus does through it’s nutrition counseling. 4. Describe the development/progress made on the Healthy People 2020 Clinical Project. a. This week in clinical I made progress toward the Healthy People 2020 Clinical Project by asking the nurse in the asthma clinic in which...
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...Populations Jennifer Maas NUR/440 August 11, 2011 Marie Fagan MN, RN Vulnerable Populations Vulnerable populations are social groups who experience health disparities as a result of a lack of resources and risk factors. In this paper the vulnerable group of the homeless will be discussed. The homeless population has many barriers that make obtaining healthcare a challenge. This paper will discuss the barriers and personal experiences with this demographic group. Vulnerable Population Definition Vulnerability and vulnerable populations are significant issues in today's health care system. Vulnerable populations are social groups who experience health disparities as a result of a lack of resources and increased exposure to risk. Vulnerable populations are those who are made vulnerable by their financial circumstances or place of residence, health, age, personal characteristics, functional or developmental status, mental or physical status (Goliath on Demand, 2011). The homeless is one of the many vulnerable population groups and is a very problematic issue currently. Barriers of the Homeless There are many barriers of the homeless however the one that stands out is the lack of access to health care. Many of the homeless live on the streets in dirty, filthy conditions which put them are risk for illness. They do not have the finical means or insurance to access preventive or acute care if needed. Many...
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...Health Promotion among Diverse Populations Eric Valdez Rasmussen University Health Promotion among Diverse Populations As this paper has been researched and written, this nurse has realized that our Hispanic Americans have a profound sense in their culture still imbedded within them to this day. Hispanic socioeconomic status, education background, culture and beliefs impact their health in such tremendous ways that it is difficult to believe that the healthcare system in America didn’t start enforcing patient learning strategies and patient education sooner. According to the 2012 U.S. Census bureau report, the average Hispanic median household income was $40,417 in comparison to $56,565 for non-Hispanic Whites for full-time employment. In 2012, the U.S. Census bureau reported that 25.4 percent of Hispanics in comparison to 11 percent of non-Hispanic Whites were living in poverty ("HHS," 2015, para. 4). With this being mentioned, Hispanics maintain their health by utilizing their cultural upbringing rather than entertaining the thought of utilizing modern medicine due to the high cost of health care and insurance. This poses the largest of dilemmas. Shorter life spans while living in the states is on the up rise for the Hispanic population as they are acclimating to America’s rushed lifestyle and poor diets. (This is occurring more so for the Hispanic Americans than Hispanics born to their native countries, but this is increasing). The challenge now is for the healthcare...
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...Diabetes Speaker Notes Slide 2- This presentation will discuss the goals of Healthy People 2020 with the focus of the presentation on Diabetes. It will define diabetes and the age groups affected by the illness. We will discuss the reason the Red Group felt this focus area was important. The presentation will identify ways to enhance or optimize diabetic health. Health disparities among different populations in the United States will be discussed. Community resources will be identified for patient and family education. The American Diabetic Association will be discussed as well as some of the programs they offer. Slide 3- Healthy People provides Science Based, 10 year national objectives for improving health of all Americans. Healthy People for three decades has set national goals and monitored them to encourage collaborations across communities and sectors, empower individuals toward making informed health decisions, and measure the impact of prevention activities. (Healthy People. gov, n.d.) Slide 4- We felt this was an important topic because diabetes affects all age groups from children, teens, young adults, pregnant women to older adults. This disease doesn't discriminate who it attacks. Diabetes involves multi-organ body systems including the eyes, vascular system, and urinary system. Many Americans have lost their vision, limbs, kidney function and even their life to this disease. We felt education is important because many people still don’t know what diabetes...
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...According to the assigned article, "Health Disparities and Structural Violence: How Fear Undermines Health Among Immigrants at Risk for Diabetes. In and effort to Explain the relationship between fear and health identified by the researchers in the article I will start with this issue of cost pointed out in the article. People are afraid to seek health care because they cannot afford the copays, or the medical bills to follow. According to the article, the people in the international district are left with choices to make such as pay for healthcare now or be left in the cold, dark, no food or water and possibly get thrown out in the streets along with their families, possibly young children in the mix, these children's needs takes precedence of healthcare for the adults. The people consider the fact that diabetic complications are not imminent. Eventually, they make a choice to suffer in silence until their health gets out of control, to the point where they cannot tolerate it anymore. At this point, there is not much that can be done for them because the prompt diagnosis has not been made prior to the complexity that they present with to the doctor. There are also the issues of them being unable to discern the bills and not sure how to go about getting the bills settled. Keeping in mind that they are undocumented, they are fearful of deportation, they are stressed out and we all know that stress plays a major role in the exacerbation of any diagnosis especially diabetes...
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...Vulnerable Populations Vulnerable populations are social groups who experience health disparities as a result of a lack of resources and risk factors. In this paper the vulnerable group of the homeless will be discussed. The homeless population has many barriers that make obtaining healthcare a challenge. This paper will discuss the barriers and personal experiences with this demographic group. Vulnerable Population Definition Vulnerability and vulnerable populations are significant issues in today's health care system. Vulnerable populations are social groups who experience health disparities as a result of a lack of resources and increased exposure to risk. Vulnerable populations are those who are made vulnerable by their financial circumstances or place of residence, health, age, personal characteristics, functional or developmental status, mental or physical status (Goliath on Demand, 2011). The homeless is one of the many vulnerable population groups and is a very problematic issue currently. Barriers of the Homeless There are many barriers of the homeless however the one that stands out is the lack of access to health care. Many of the homeless live on the streets in dirty, filthy conditions which put them are risk for illness. They do not have the finical means or insurance to access preventive or acute care if needed. Many have chronic illness that go untreated and exacerbate and even cause death. Fear, embarrassment and mental disorders also can...
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...Three Abbreviated Research Plans Introduction This paper demonstrates research methods that are used in investigations of health disparities in the United States. Research is a process of investigating concepts and theories that will contribute to a scientific body of knowledge. When presented with a problem, researchers or healthcare specialist can use a quantitative, qualitative or mixed methods approach to solutions or explore avenues that might improve health, health outcomes and health services (Bowling, 2002). As health disparities grow in the United States and research is ongoing, three abbreviated research plans are presented as probable solutions to this concern targeting communities and populations that are underserved. Comparison and Evaluation of Strengths and Limitations of Research Methods Used in These Abbreviated Plans Research is an organized investigation to explain, describe, and control an observed phenomenon that involves inductive and deductive methods. Researchers will use a quantitative research design to verify that the research method used is valid and will produce accurate scientific results (Vidgen, n.d.). The strengths involved in using the quantitative research method can test and validate theories that have been already formed about why and how phenomena occur. Quantitative research allows the researcher to measure and analyze data that is précis which may help eliminate the influence of many variables and allow more reliable cause-and-effect...
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...Health Promotion Among Diverse Populations Kristi Donau Grand Canyon University Family Centered Health Promotion NRS-429V Dana McKay May 3, 2015 Health Promotion Among Diverse Populations The United States has seen much transformation within its healthcare advances and delivery system over the last century. It has also demographically transformed from a nation of a predominantly white population to an ever growing culturally diverse population. Many of these cultural groups are documented minority groups, which face many problems with accessing and receiving adequate health care. Looking at the 2010 U.S. Census, close to 36 percent of the population was a part of an ethnic or racial minority group. These minority groups include American Native Indian, African American, American Asian, Pacific Islander, and Latino or Hispanic. Some minority groups have increased risk factors and experience a greater and disproportionate burden of disease, preventable illnesses and disability and morbidity rates compared with non-minority groups ("Centers for Disease Control and Prevention," 2014). In this paper, the author will compare and contrast the health status for the minority group of Hispanic/ Latinos to the national average, describe how health promotion is defined and what barriers and disparities exist for this minority population, and will describe three levels of health promotion prevention and which would be optimal for teaching the Hispanic/Latino people. ...
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...diabetes so that education and management of diabetes will continue during school hours. Mississippi State uses programs like these to address the incidence of diabetes in the state. The incidence and measurement of diabetes in the state, and at the county level, is completed yearly and quarterly and the state research agencies collaborate with the federal government both in the reporting requirements and in the building of programs that address the findings from the reports. The state of Mississippi has one of the highest prevalence of diabetes in the country. Public health officials in the state of Mississippi understand that accessibility to health care research is basis for accurate surveillance efforts. The goal for this research proposal is to identify and create a culture of wellness for individuals living with diabetes. The Mississippi Diabetes Prevention and Control Program (DPCP) have teamed up with public health officials in an effort to facilitate the accessibility of diabetes control programs. Extra efforts are made in areas that are highest in prevalence with diabetes. Diabetes programs are being created in an effort to enable awareness and diabetes prevention. Self-management proposal/programs are included so that individuals living with diabetes can lead a healthy life. Mississippi has implemented a research proposal and programs that will target school children with diabetes by teaming up with public school officials. Population and Data Targets At the national...
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...Pay-for-Performance Emergence of Pay-for-Performance In 2000, the Institute of Medicine (IOM) released the report “To Err is Human: Building a Safer Health System.” The report catalyzed the attention of health care stakeholder groups in the nation (Stafford, 2000). The research provided a comprehensive, detailed account of health care errors and preventable deaths costing billions of unnecessary dollars in a health care system already spiraling out of control. The IOM recommended that Congress create a Center for Patient Safety within the Agency for Health Care Research and Quality for the purpose of designing a safer health care delivery system. Fifteen months after releasing the patient safety report, the IOM released “Crossing the Quality Chasm.” The report framed underlying reform necessary in the current health care delivery system to ensure patient safety. The framework sought to hold providers accountability for the quality of care they deliver. The introduction of the pay for performance (P4P) as opposed to the prior fee for service and prospective reimbursement guidelines induces delivery of care based upon performance measures. Broadly defined pay-for- performance includes any type of performance-based provider payment arrangements, including those that target performance on cost measures (U.S. Department of Health & Human Services, 2006) Reimbursement Pay-for-performance, synonymous with quality-based purchasing, bases reimbursement upon quality measures....
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...Diabetes Mellitus among African Americans Final Research Paper Peggy Hollie Epidemiology Disease Dr. Peters May 9, 2012 Diabetes Mellitus is characterized by abnormal metabolism of carbohydrate, protein, and fat, resulting in increased levels of blood sugar. The adjective mellitus (for sweet) is used with diabetes insipidus (tasteless), which is so rare that the word diabetes by itself generally refers to diabetes mellitus. The only thing that diabetes mellitus and diabetes insipidus have in common is polyuria, or frequent urination. There are two forms of diabetes mellitus: Type I, or insulin-dependent diabetes mellitus IDDM), and Type II, or non-insulin-dependent diabetes (NIDDM). Diabetes is one of the ten leading causes of death from disease in the United States. It is the result of an insufficient supply of insulin or an inadequate use of insulin that is supplied from the islets of Langerhans in the pancreas. According to Centers for Disease Control and Prevention CDC (2010), diabetes affects 25.8 million people 8.3% of the U.S. population, diagnosed 18.8 million people and undiagnosed 7.0 million people. African Americans who have diabetes are 4.9 million or 18.7% aged 20 years or older. African Americans are twice as likely to be diagnosed with diabetes as non-Hispanic whites. In addition, they are more likely to suffer complications from diabetes, such as end-stage renal disease and lower extremity...
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...Health Promotion among Diverse Populations Grand Canyon University Family-Centered Health Promotion NRS-429V Michelle M. LeRoy January 18, 2015 Minority health determines the overall health of our nation. According to the 2010 U.S. Census, 36% of the population belongs to the minority groups. While even some of the health outcomes have improved for most Americans, some of the minorities still suffer a large burden of preventable diseases and disabilities. Between 2000 and 2010, more than half of the U.S. growth was due to the increase in the Hispanic or Latino population. Data from the U.S. Census, will help the public and private institutions to find areas where special services in education, housing and healthcare are needed. The importance of this paper is to explain the current health status, health promotion, and health disparities of the Hispanic/Latino population. Current Health Status of the Hispanic or Latino Population According to the Vital & Health Statistics, as of December 2013, the percent of Hispanic or Latino persons of all ages in fair or poor health is 10.3%. The non-Hispanic Whites in fair or poor health is 9.8%. These numbers of fair and poor health are comparable. However, the percent of persons in excellent or very good health of all ages in the Hispanic race is 63.2% compared to non-Hispanic White race of 66.8%. As shown in the CDC statistics, the Top 10 leading causes of death in Hispanics and non-Hispanic Whites differ greatly. The...
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...Educational Preparation: ADN versus BSN Prepared Registered Nurses Grand Canyon University: NRS 430-V Professional Dynamics September 23, 2012 Three different pathways exist to educate students with the knowledge needed to be able to sit for the NCLEX-RN licensing exam. The American Association of Colleges of Nurses states “the NCLEX-RN exam measures the minimum technical competency needed to practice as a registered nurse” (2012). The nursing student may complete his or her education over two to four years. The first, a hospital based program, requires three years to complete. Graduates receive a diploma, not a degree. “Approximately 54 diploma programs remain, in the United States” (Creasia & Friberg, 2011). The second, a community college based program, requires two to three years to complete. Graduates receive either an associate of science in nursing degree (ADN) or an associate of arts in nursing degree (AAN). “In 2009, 980 ADN/AAN programs were in existence, in the United States” (Creasia & Friberg, 2011). The third and final pathway, a traditional college or university based program, requires four years to complete. Graduates receive a bachelor of science in nursing degree (BSN). “In 2008, 748 BSN programs were in existence, in the United States” (Creasia & Friberg, 2011). ADN/AAN and diploma level education is comparable. The number of diploma programs is small compared to the number of associate and baccalaureate programs; therefore, I will...
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...Health Promotion Among Diverse Populations: Asian Americans Courtney Rasmussen Grand Canyon University February 15, 2015 In 1849, the Chinese were some the first ethnic group that many refer to as Asian Americans and later as Asian American/Pacific Islanders (AAPI). (Kem B. Louie, 2001) “Asian” however, refers to a very diverse group of people that come from over fifty (50) different countries, that speak more than one hundred (100) different dialects, which practice a broad range of different religions, and lead a variety of lifestyles. People from as far east such as Southeast Asia, Thailand, Vietnam, the Philippine Islands, Japan, the Indian subcontinent including for example Cambodia, Indonesia, China, Korea, Pakistan, Nepal, Taiwan, and Malaysia. (Office of Minority Health and Health Equity, 2013) Asian Americans are often stereotyped as the “model minority,” and are perceived to be in tiptop health and have financial security. Therefore, their health concerns are often overlooked or quite frankly, often times, a language barrier is what stands between them and their health. Heart disease and Cancer are the leading causes of death in AAPI. (Office of Minority Health and Health Equity, 2013) And, approximately two million AAPI are uninsured in this country. While AAPI’s are less likely to live in poverty and more likely to graduate from college and have a management position, there remain still, several startling health disparities for this population of people. (Office...
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