Determinants of Health NR 443 essay assignment discussion papers

Determinants of Health NR 443 essay assignment discussion papers

Determinants of Health (graded)

Healthy People 2020 identified four Foundation Health Measures (FHM) that reflect the major health concerns in the United States. The third FHM is Determinants of Health. The description of Determinants of Health is:

“A range of personal, social, economic, and environmental factors that influence health status are known as determinants of health. Determinants of health include such things as biology, genetics, individual behavior, access to health services, and the environment in which people are born, live, learn, play, work, and age” (U.S. Department of Health and Human Services, n.d., About Determinants of Health section, para. 1).

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Go to the “Learn More About Determinants of Health” ( http://www.healthypeople.gov/2020/about/DOHAbout.aspx ) and choose one of the five Determinants of Health that you feel is most important for community health. In your posting, share the determinant of health and the rationale for your choice. Remember to cite any references used for developing your rationale.

Please note:

There is a helpful “Orientation to Healthy People 2020” document in Doc Sharing.

Our textbook, Community/Public health nursing: Promoting the health of populations (5th ed.) was published prior to the final version of Healthy People 2020 resulting in some of the book content differing from the Healthy People 2020 website.

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(an instructor response)

Collapse              Mark as Read    Determinants of Health                Instructor Hamilton Email this Author     2/17/2015 8:27:50 PM

Class,

As mentioned there are five determinants of health.  As you look at these and view the website and the video which of these determinants do you consider to be the most important?  We probably all have one that we feel is the most important.  There are some of the determinants which our populations have no control over.  How is this important in public health nursing?  Your thoughts?~Dr Hamilton

Please remember to cite your sources.

Class: You may begin posting in this TD on Sunday, March 1, 2015 for credit.

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Collapse              Mark as Unread               RE: Determinants of Health         Erica Meyerhofer Email this Author         3/1/2015 6:56:17 AM

Main Post Determinants of Health Week 1

 

Professor Hamilton and Classmates

 

The five determinants of health according to Healthy People 2020 are policymaking, social factors, health services, individual behaviors, and biology and genetics.   Determinants can be applied to answer why some people are healthier than others and what can we do in the medical profession to build a society where everyone can live a long healthy life (HealthyPeople.gov).

 

Health Services tops the list for me.  Even with Obama’s health care reform many American’s are still without insurance.  Contrary to the believe affordable health care it is not affordable for all.  Public health relies on a preventative approach to health (Nies & McEwen, 2011).  If health services cannot be obtained by the public due to lack of coverage, high costs, and lack of availability we will not be able to apply a preventative approach (HealthyPeople.gov).  There are three levels of prevention.   Primary which focuses on prevention before the problem occurs. Secondary prevention refers to screening exams to monitor a problem before signs and symptoms begin.  Tertiary Prevention attempts to avoid the progression of the disease or injury the patient has experienced (Nies & McEwen 2011).  If the public does not have access to quality health services the preventative approach to public health cannot exist that is why I feel health services is most important. Determinants of Health NR 443 essay assignment discussion papers.

 

Social and physical determinants cannot be entirely controlled by population.  Public health nursing brings nursing to the people.  Many times people do not have transportation to access health care by offering it in the homes of those who cannot drive or walk to a health care facility can positively impact the health of all community members.  This philosophy dates back to 1877 when Frances Root was providing in-home care to the sick (Nies & McEwen, 2011).  Where we can afford to live can control our ability to live a long healthy life if we live in a high crime area we are subjected to crime by violence.

 

Erica Meyerhofer

 

References:

 

Nies, M. A. & McEwen M. (2011).  Community/Public health nursing: Promoting the health of populations (5th ed.). St Louis, MO: Saunders/Elsevier.

 

HealthyPeople.gov. (2015). Determinants of health. (n.d.), http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health

 

 

 

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Collapse              Mark as Unread               RE: Determinants of Health         Arthel Tamakloe Email this Author           3/4/2015 11:12:12 PM

Determinants of health include things such as biology, genetics, individual behavior, access to health services, and the environment in which people are born, live, learn, play, work, and age. These are all important but I chose to write biology and genetics.

Biology refers to things both inside and outside of our bodies. The biological determinants outside of our bodies are living things that we come in contact with.  These could be anything from bacteria, bugs, or animals. These things can affect us in good and bad ways.  If we are exposed to something harmful, our body’s immune system will respond and fight off the infection.

Genetic is the things that are passed down from parents and ancestors. Things can be physical characteristics as well as hereditary health issues. Things like allergies or other diseases can be passed generation to generation.

The knowledge of biology and genetics are in important in public health nursing because early intervention is very important. Some genes do not necessarily cause disease, and instead predispose a person to a disease such as heart disease, cancer, and diabetes.

 

References

 

HealthyPeople.gov (2015). Determinants of Health. Retrieved from: http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health

 

http://www.ouragenda.ca/resource/Resources/TabId/234/PostId/7/Biologyandgeneticendowment

 

 

 

 

 

 

 

 

Respond Edit

Collapse              Mark as Read    Determinants of Health                Anzhelika Antyasova Email this Author   3/1/2015 1:16:06 PM

Dr.Hamilton and class,

 

5 Determinants of Health are policymaking, social factors, health services, individual behavior, biology and genetics.

Individual Behavior

Determinants of Health NR 443 essay assignment discussion papers Individual behavior is very important aspect in health outcomes. As I already spoke about tobacco use in my  TD#1 I think this is the great example in individual behavior. If an person quits smoking, risk of heart disease or respiratory diseases  reduced. Public health and health care concentrates on changing individual behaviors as diet, physical activity, hand washing, alcohol, cigarets use. Thereby, reduce health risk, and improve health status positively. It is very important to remain physically active , it will help to reduce the risk of cardiovascular deceases. Hand washing will help to avoid infections disease.

Retrieved from:

 

http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health#health%20services

 

 

 

Respond

Collapse              Mark as Read    RE: Determinants of Health         Erica Meyerhofer Email this Author         3/2/2015 9:17:38 PM

Modified:3/2/2015 9:18 PM

Anzhelika

 

Individual behavior I have to agree is very important but what if the person was unable to obtain the resources required to quit smoking, join an exercise club, or afford healthy food for diet?  Are their free services offered to these individuals in your area?  I know we have a 1-800 quit line for smoking that offers some assistance to patients within our practice.  We live in Wisconsin so weather is not always the best for outdoor exercise and the health clubs in this area are not affordable.  I deal with many patients that would love to go to the gym to swim or walk indoors but simply cannot afford to do so. I am fortunate I can afford to buy healthy food choices for my family but I work with many who are not so fortunate and there are not programs out there for people to afford to buy proper food choices.  Of course then there are people who can afford to smoke and drink but claim they cannot afford to buy fruit and vegetables or buy a gym membership and that is where behavior choices play a major factor in optimize health.

 

I was an ex-smoker there were two things that made me quit.  First being policymakers the cost was outrageous so I am VERY thankful for the taxes they added to cigarette (healthypeople 2020) and the second reason was I knew better as a nurse  you see patients everyday struggling to breath and like you said everyday they do not smoke reduces their risk for cardiovascular and respiratory disease.

 

Erica

Refhttp://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Healtherences:

 

 

 

 

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(an instructor response)

Collapse              Mark as Read    RE: Determinants of Health         Instructor Hamilton Email this Author     3/3/2015 4:58:27 PM

Anzhelika, Erica, and Class,

What changes would need to happen in the community for the determinant of health you chose to improve?  You selected some common barriers allowing me to reflect back on my days as a public health nurse…Feel free to jump in class, share what you may be witnessing in your own community…I see farmers markets, COOPs and SHARE programs, energy assistance, diaper drives, holiday baskets, all with the intention those with limited incomes can apply their finances toward health care and living expenses if needed, or save some money for future needs. But again these have limitations.~Dr Hamilton

 

 

 

 

 

Respond

Collapse              Mark as Read    RE: Determinants of Health         Anzhelika Antyasova Email this Author   3/4/2015 8:25:25 PM

Erika, I agree with you, there is people on the street with low income, and they can not afford quitting , buy patches, or anything else. Unfortunately in my practice people are trying to quit when already diagnosed with certain disease, and were told by the doctor that the life is in their hands. So far, this is the one of the main  reasons for some people to quite smoking. You asked me if we have free services? I should say there is a lot of websites with a offers of free kits, phone lines. For example http://myquitkit.org, and there is not the only one.

Determinants of Health NR 443 essay assignment discussion papers I am lucky that I never smoked, and never will, simply because I just Do not like it. And I understand that it is easy to say then do. At the same time I believe quite smoking  is possible if person really needs and wants. As my friend did when his child made a wish for his birthday that wants his Daddy to quite smoking. That was the last day when my friend smoked. And at this point income and free services were not necessary.

 

Thank you.

 

 

 

Respond

Collapse              Mark as Read    RE: Determinants of Health         Erica Meyerhofer Email this Author         3/6/2015 5:27:29 PM

Anzhelika you are absolutely correct when someone really wants to quit they do.  I smoked from the age of 17 until I was 35.  I had my children at 26 and never a day in their lives did they know that I smoked only until after I quit.  I never wanted my children to know that I smoked. I grew up in a house where my father smoked and hated it that is why my mom was so surprised that my sister and I choose to smoke.  My calling was when my daughter started to smell smoke on me and found a lighter in my purse.  One could only lie so long so that was it for me

 

 

 

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Collapse              Mark as Read    RE: Determinants of Health         Kathryn Dore Email this Author  3/7/2015 1:19:57 PM

Erica,

 

I want to say to you great job on quitting smoking.  Whatever the reason was you stopped and are taking action in your health.  I agree with the higher taxes on cigarette.  I think for a lot of people they start when they are young and don’t think about the health risks.  They will see it when it impacts their money.  Although, I have seen smoking affect people in high school, at gym they can’t run as well as they used to, coughing more.  I wish that there is more out there to get kids not to start smoking.  I know that there is a lot out there, but I feel that there could always be more.

 

 

 

Respond

Collapse              Mark as Read    RE: Determinants of Health         Vanessa Machado Email this Author        3/8/2015 9:24:43 PM

 

Erica,

 

I agree that individual behavior is a key factor regarding health wellness and promotion.  As you stated, though, upon further questioning, does that person have what they need to positively act on their behavior. Determinants of Health NR 443 essay assignment discussion papers. This is where the determinants of health overlap.  Individual behavior for example, is influenced by the person or community’s knowledge level.  First, one must assess the community’s knowledge base and then ask are people being educated adequately regarding key health issues in their community?  Are they aware of the resources that a community has to assist them in achieving their health and wellness goals-as you stated-maybe related to assistance from their city or town in regards to ways to attain affordable healthy foods.  As Atrash & Carpentier state, “Three services support the core function of Policy development: informing, educating and empowering people about health issues; mobilizing community partnerships to identify and solve health problems; and, developing policies and plans that support individual and community health efforts. And, four services support the core function of Assurance: enforcing laws and regulations that protect health and ensure safety; linking people to needed personal health services and assuring the provision of health care when otherwise unavailable” (2012).

 

The Institute of Medicine (IOM) further identified two functions provided by all public health agencies and include “Policy development, defined as formulating public policies, in collaboration with community and government leaders, to solve identified local and national health problems and priorities, and, Assurance, defined as assuring that all populations have access to appropriate and cost effective care, including health promotion and disease prevention services, and evaluation of the effectiveness of that care” (Atrash & Carpentier, 2012).

 

Although the main responsibility for public health resides with the departments of health at the local, state or national levels, the success of public health depends on the coordination of efforts and collaboration between these departments and workers in other components of the health care system, other government agencies, community-based organizations, as well as private organizations.

 

Thank You,

Vanessa Machado

 

 

 

Reference:

Atrash, K., & Carpentier, R. (2012). The evolving role of public health in the delivery of health care. Revista brasileira de crescimento e desenvolvimento humano, 22(3), 396-399. Retrieved from:  http://pepsic.bvsalud.org/scielo.php?pid=S0104-12822012000300017&script=sci_arttext

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Respond

Collapse              Mark as Read    Health Services Jessica Parker Email this Author 3/1/2015 2:11:02 PM

Professor Hamilton & Class:

 

Under Determinants of Health (HealthyPeople.gov), I chose Health Services.  If there is a lack of services or lack of health insurance coverage for services, people will be less likely to get the preventative care they need.  We, as nurses, can work to provide interventions to help improve health in our communities (CCN, 2015).  If the services are not available or not affordable, people cannot be provided the needed services.

 

As stated by Nies & McEwen (2011), people are many times more concerned with quality-of-life ideals rather than their health.  Although, having access to quality healthcare can add to the quality (& quantity of years) of a healthy life.

 

Chamberlain College of Nursing. (2015). NR-443 Week 1: Introduction and History of Public/Community Health Nursing [Online lesson]. Downers Grove, IL: DeVry Education Group.

 

HealthyPeople.gov (2015). Determinants of Health. Retrieved from: http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health

 

Nies, M. A., & McEwen, M. (2011). Community/Public health nursing: Promoting the health of populations (5th ed.). St. Louis, MO: Saunders/Elsevier.

 

 

 

 

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(an instructor response)

Collapse              Mark as Read    RE: Health Services          Instructor Hamilton Email this Author     3/2/2015 5:47:40 PM

Thanks for the post Jessica, This leads me to the question …what consequences would the community face if the determinant of health you chose does not improve? I am wondering if corrective measures are currently introduced or if you are witnessing any community health nurse or public health initiatives?~Dr Hamilton

 

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Collapse              Mark as Read    RE: Health Services          Jessica Parker Email this Author 3/3/2015 6:26:45 PM

Professor Hamilton & Class:

 

I am seeing more people without insurance that would rather pay the fine for not having health insurance than to pay for the government provided insurance that does not have very good coverage.

 

Our community offers a lab one day quarterly at a discounted rate (only $25!) that will show results for some basic labwork (lipids, glucose, CBC).  Many do not take advantage of this service though.

 

Jessica

 

 

 

 

Respond

Collapse              Mark as Read    Determinants of Health                Tasha Forehand Email this Author            3/2/2015 3:10:10 PM

Class and Dr. Hamilton,

 

I believe that Individual Behavior is the most important determinant for community health.  After looking through the list I strongly believe that this determinant is the one that the individual absolutely has the most control over.  We as individuals have to make a decision to be healthy or we won’t be.  There are factors that affect us that we have no control over but this particular determinant is completely in each individuals control in my opinion.  The Individual Behaviors that were listed were diet, physical activity, alcohol, cigarette and other drug use, and hand-washing.  These are all things that we can choose to do or not to do.  There are an abundance of online resources to look at in order to determine what a healthy diet is, how much physical activity we should engage in, the use of alcohol and the risks and benefits associated with it, the use of cigarettes and other drugs and the risks associated with them, as well as the importance of hand-washing to stop the spread of bacteria and germs.  It seems like everywhere I go there are teaching tools to encourage a healthy lifestyle.  As nurses in the community it is our job to make certain that the people in the community are well-educated on these topics.  The hospital in the town that I live in often offers free classes for the community in regards to these topics.  They also have a class that you can take where you go and prepare a week’s worth of healthy meals that can be frozen so that you have healthy meal options for your family.  The resources are endless and I believe it truly is based on making the decision that you are going to live a healthy lifestyle to the best of your control.  We cannot control our genetic makeup but we certainly control how we feed in to it.

 

Reference:

 

http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health#individual behavior

 

 

 

Respond

(an instructor response)

Collapse              Mark as Read    RE: Determinants of Health         Instructor Hamilton Email this Author     3/2/2015 5:45:44 PM

Tasha

Great post, Behavior I agree but cycling around to challenge the others are affordability of housing, need for public transportation, and job market. Rural compared to Urban will vary, where are the social supports of the family, and is the job market comparable to the cost of living…you made me think 🙂

Dr Hamilton

 

 

 

 

Respond

Collapse              Mark as Read    RE: Determinants of Health         Pamela Mintz Email this Author 3/7/2015 4:13:18 PM

Tasha – You hit a lot of great points in your post. Individual behavior is a huge! The new year is always one that you can see the diet and physical activity aspect in full force. People will sign up for a gym, trying to exercise more and watch their diets. Then a few weeks or months later, they aren’t using that gym membership anymore. Bachman wrote that “the decline starts as early as the third week in January” (2015, para.  4). Determinants of Health NR 443 essay assignment discussion papers. Why? It’s their own individual behavior. You have to be the one to drive your own ambitions, your health.

 

I have been around two males that used tobacco products. They knew the negative health effects of smoking/chewing, but still engaged in it. It was interesting to see that something finally motivated each one to quit. Whether it was another person, or for their own health, they quit using tobacco – they changed their individual behavior in regards to it. No one could do it for them – they individually had to.

 

I agree with what you wrote about resources. Some communities are abundant with them – I know I see and hear about resources in my county quite often. Sometimes they are visible, but other times you may need to search a bit (online, library, hospitals, etc.).  I feel there is lot of teaching a community nurse could do in regards to individual behavior. One of my nurses at work does this every single day. She’s visiting patients in their homes, teaching them ways to eat healthier, live healthier, and assisting them with finding resources to help.

 

Pam

 

Reference

 

Bachman, R. (2015, January 19). The Week Your New Year’s Resolution to Exercise Dies. The Wall Street Journal. Retrieved from http://www.wsj.com/articles/the-week-your-new-years-resolution-to-exercise-dies-1421703411

 

 

 

 

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Collapse              Mark as Read    Individual Behavior         Stephanie Stalter Email this Author          3/2/2015 7:39:44 PM

Dr Hamilton and Class,

 

The one “Deteminants of Health” that I really appreciate is the “Individual Behaviors” section. I feel that people need to be responsible for their own health, especially the parts that they can control. I understand that many people have diagnosis that are related to heredity or circumstance, but individuals need to be responsible for what they can be. According to HP2020, “Individual behavior also plays a role in health outcomes… Positive changes in individual behavior can reduce the rates of chronic disease in this country. ”

Healthy People 2020 identify some of these changes as:

Diet

Physical activity

Alcohol, cigarette, and other drug use

Hand washing

The entire culture of health care is moving towards “wellness”  as a goal. Maintaining and returning to wellness. But, people need to take responsibility for their own health. They need to be educated to make decisions which support and encourage a healthy lifestyle, rather than allowing problems to occur and then trying to fix them. Additionally, according to the United States Department of Labor Fact sheet, “Implementing and expanding employer wellness programs may offer our nation the opportunity to not only improve the health of Americans, but also help control health care spending.”

 

Thank you,

 

Stephanie Stalter

 

 

United States Department of Labor: The Affordable Care Act and Wellness Fact Sheet. 2015

 

 

 

Respond

Collapse              Mark as Read    RE: Individual Behavior  Ashley Peterson Email this Author           3/4/2015 9:37:46 PM

Stephanie,

I agree individual behavior is key to the determinants of health. If a person doesn’t have a positive attitude toward their health, it will reflect in their health. For example you stated diet, if a person doesn’t have concern or positive attitude and good behaviors when eating they are more likely to have heart disease, obesity, and type two diabetes. If a person doesn’t have the right attitude, you’re not going to change their health behaviors.

 

Ashley

 

 

 

Respond

(an instructor response)

Collapse              Mark as Read    RE: Individual Behavior  Instructor Hamilton Email this Author     3/5/2015 6:25:30 PM

Stephanie

Sometimes this seems like there’s no hope, but there are cities that have rallied and worked together to make changes step-by-step to turn things around. This involves forming coalitions with key stakeholders in the city and getting the citizens involved and motivated. Public health nurses can play a key role in leading revitalization efforts, development of self help initiatives, and community support groups.There are government grants and private funding available for city revitalization projects which may include neighborhood watch, planting community gardens, etc. but it does take time to decide on the top priorities and apply for available funds. You may find that there are those in your community who have started these efforts as you begin your assessment of your community. Determinants of Health NR 443 essay assignment discussion papers. Excellent post, thanks for the topic!~Dr Hamilton

 

 

 

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Collapse              Mark as Read    RE: Individual Behavior  Jeremiah Ozuna Email this Author            3/6/2015 3:11:44 PM

Hello Stephanie,

 

I really enjoyed your post. I completely agree it is a persons responsibility for their health. What is difficult to do is, yes we can educated people, but how can we ensure that they are actually trying to get healthier. Also how do we continue getting people to keep healthy? As professor said in my post, most people find it easy to gravitate back to their old ways of eating and lifestyle. What are ways to keep people on track?

 

Jeremiah

 

 

 

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Collapse              Mark as Read    RE: Individual Behavior  Erica Meyerhofer Email this Author         3/6/2015 5:33:45 PM

Jeremiah and Class –

 

In today’s world everyone has a cell phone and for those who want to continue a healthy life style there are many apps to keep people on track. In our practice when people arrive asking for help in weight loss we explain the obviously health eating and exercise but we also encourage them to use My Fitness Pal. Determinants of Health NR 443 essay assignment discussion papers. It can help track caloric intake, exercise, to reach a weight loss goal.  People often do not realize how many calories they actually consume until they start tracking it, it can be a real eye opener.  I recently purchased a fitbit and absolutely love it.  I know they are not affordable to all but the My Fitness Pal is a free app that most can download on their cell phones that they already carry around with them.

 

 

 

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Collapse              Mark as Read    RE: Individual Behavior  Danielle Devito Email this Author              3/6/2015 3:45:21 PM

 

Stephanie,

 

I agree with you that Individual behavior is such an important determinant of health.  What is that saying, you can lead a horse to water but you can’t make it drink?  Working in healthcare we see so many people that are in the hospital over and over again because we treat them and educate them, but then they go home and eat Chinese food, even though they have CHF, or continue to smoke even though they have COPD.  But then they are angry that they are always in the hospital and why aren’t we doing anything to help them?  According to Nies and McEwan (2011) 20% of the annual deaths in the United States were due to smoking, 14% of deaths were related to poor diet and activity, and 5% of deaths were from alcohol (either because of accidents, homicides or diseases caused by alcohol).  These are all deaths that are due to individual behavior, that are preventable by a change in lifestyle.  All we can do as nurses is educate and hope that someone learns from us and decides to change their ways.

 

References

 

Nies, M. A., & McEwan, M. (2011). Health: A community view. In Community/Public health nursing: Promoting the health of populations (5th ed. (pp. 2-17). [VitalSource]. Retrieved from www.vitalsource.com Determinants of Health NR 443 essay assignment discussion papers

 

 

 

 

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Collapse              Mark as Read    Individual behavior         Jemima Gutierrez Email this Author         3/2/2015 11:53:29 PM

Hello Dr. Hamilton and class,

A determinant that I choose has a lot to do with individual behavior which account for seventy-percent of all premature deaths in the United States (USDHHS, 2000). It will have the biggest impact on the person’s well being and its impact on the community health as a whole. Poverty, a key health determinant in the rural area is not controllable and so as lack of physicians in the rural area that are not easily available and are more available specialty physicians and transportation into than the urban areas. Individual behaviors that are controllable and can be changed, such as improvement of health condition with the help of changes in the diet, smoking cessation, and refraining from alcohol consumption that leads to diseases can be reduced if the individual makes the willingness to change behavior for the better of their health. Diet alone makes up of about 300,000 per year of deaths and alcohol with 5% of deaths because it becomes associated with suicides, homicides, and cirrhosis or chronic liver disease (Nies, 2011). Determinants of Health NR 443 essay assignment discussion papers Disparities such as the socially disadvantage may not have the medical insurance, lack of money to pay medical physician, transportation to get to the medical health facility or medication contributing to the problem. According to Nies, public health nurses is defined as “the practice of promoting and protecting the health of populations using knowledge from nursing, social, and public health sciences” (ANA/APHA, 1996, p. 5). It is essential for the community health nurse to understand the determinants of health and recognize the interaction of the factors that lead to disease, death, and disability The nurse plays pivotal role in their community outreach, engaging in activities that increase knowledge, motivating, adapting to the health education, to each person from infants, children or adult helping these information accessible for the public and facilitating implementation of the process to help the community get the information and education”(Nies, 2011).

 

American Nurses Association: In Public health nursing: scope and standards of practice. 2007, American Nurses Publishing, Silver Spring, MD.

 

Nies, M. A., & McEwen, M. (2011). Community/Public health nursing: Promoting the health of populations (5th ed.). St. Louis, MO: Saunders/Elsevier.

 

U.S. Department of Health and Human Services: In Healthy People 2000 objectives. 1989, The Author, Washington, DC.

 

 

 

 

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Collapse              Mark as Read    Determinants of Health                Danielle Devito Email this Author              3/3/2015 1:52:23 PM

Dr. Hamilton and Class,

 

I chose Biology and Genetics because I feel like it is one of the most important factors. “Some biological and genetic factors affect specific populations more than others,” (HealthyPeople.gov, 2015). Many people feel that they are ‘stuck’ with their health issues sometimes because of their genetics, but this is not the case. Lifestyle changes can still help to improve their overall health, even when they have issues that are inherited, such as sickle-cell anemia, breast cancer genes, or family histories of heart disease. Knowing that you are predisposed to these things is actually a benefit, because you know what to look for and hopefully how to treat it. You are not stuck with these diseases. If you have a family history of heart disease, you can go to the doctor regularly, have your cholesterol checked, blood pressure checked, and stress tests done regularly. This does not change your family history, but it puts you in charge of your health.

 

References

 

HealthyPeople.gove. (2015). Determinants of health. Retrieved from http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health#biologyandgenetics.

 

 

 

Respond

Collapse              Mark as Read    RE: Determinants of Health         Jessica Parker Email this Author 3/3/2015 6:31:15 PM

Danielle:

 

I agree with your comment about how beneficial it is to know your family history.  It is helpful to know what you may be predisposed to develop.  People need more education about knowing family history and what health issues are genetic and what to ask the doctor to check for in possible health problems.

 

Jessica

 

 

 

 

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(an instructor response)

Collapse              Mark as Read    RE: Determinants of Health         Instructor Hamilton Email this Author     3/6/2015 4:33:37 PM

Danielle and Class: thanks for the post all nurses should consider joining a professional nursing organization who uses lobbyists and research departments to support/address/propose legislation for best practice in patient care as well as job safety/satisfaction of nurses.~Dr Hamilton

 

 

 

 

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Collapse              Mark as Unread               RE: Determinants of Health         Arthel Tamakloe Email this Author           3/8/2015 7:50:02 PM

Daniell I chose Biology and Genetics as well. Yes I agree with you on the fact if someone knows that they have genes that predispose them to a particular disease then they can be more vigilant to other symptoms of that disease and seek help.Preventing the disease in the first place is by far, the best way to reduce health care costs.

 

 

 

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Collapse              Mark as Read    Health Services Lisa Robinson Email this Author 3/3/2015 2:06:22 PM

Professor Hamilton and fellow classmates-

 

I chose health services for a couple different reasons. I personally deal with patients that are upset because of access issues in healthcare. I believe that this revolves around a few different issues that could be changed or modified. I believe, at least in the area that I live in, there a number of people that are on Badgercare (state assistance) and who have no co-pays for the visits that they do have in healthcare or even see a bill to see what the visits are costing. This is payed by taxpayers and hardworking people so that they can have insurance coverage. The other reason that I chose this topic is because whereas this is a problem for a lot of different reasons, it is our job as nurses to ensure that patients in our community are able to receive the best care possible and at the appropriate times.

 

I personally think that people that are state assistance for an extended period of time tend to take advantage of the “free” services available to them and end up taking up a good number of visits for things that really either are not appropriate to be seeking medical care for or could wait to be addressed in a clinic visit versus an ED visit. Determinants of Health NR 443 essay assignment discussion papers.

 

I believe that we as nurses, especially community health nurses, need to be aware and educating the patients that are on state assistance on what is appropriate and maybe even providing them with a number for a triage nurse or screening process to call prior to making an appointment or going to the ED for something that really isn’t classified as a true emergency.

 

Lisa

 

Reference:

 

http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health#health%20services

 

 

 

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(an instructor response)

Collapse              Mark as Read    RE: Health Services          Instructor Hamilton Email this Author     3/6/2015 3:53:49 PM

Lisa and Class: here is a link for you to explore as well….Upstream thinking~Dr Hamilton

 

http://www.cdc.gov/pcd/issues/2010/jul/09_0249.htm

 

 

 

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Collapse              Mark as Read    Week 1 Jeremiah Ozuna Email this Author            3/3/2015 2:27:15 PM

Hello Prof and Class,

 

After reading the article the 5 determinants of health include policymaking, social factors, health services, individual behavior, and biology and genetics.

 

Of the five different determinants of health the one that mostly appealed to me is individual behavior. Yes all 5 are important and play vital roles in community health, but the one that stands out the most personally is individual behavior. Regardless of genetics, environment, or social factors I believe it all comes down to personal and individual behavior. People have to want to change in order to change. “For example, if an individual quits smoking, his or her risk of developing heart disease is greatly reduced” (Healthy people 2020). It is the community health nurses job to almost appeal to all people depending on the environment and economic status of the area. To change individual behavior one has to appeal and motivate them to want to change. To show them the benefits, but to also determine what is holding people back from making life altering decisions.

 

Resources

 

Healthy People 2020. (2015). Determinants of Health. Retrieved from http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health

 

 

 

Respond

(an instructor response)

Collapse              Mark as Read    RE: Week 1         Instructor Hamilton Email this Author     3/3/2015 5:00:33 PM

Jeremiah

Thanks for the post…as a seasoned CHN I always kind of lean toward the social components as being a huge factor.  It is so difficult to teach a patient something different than their culture has to offer.  I find they seem to easily gravitate back to those early teaching especially with diet and healthy lifestyles~Dr Hamilton

 

 

 

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Collapse              Mark as Read    RE: Week 1         Jeremiah Ozuna Email this Author            3/6/2015 3:07:02 PM

Hello Prof,

 

What kind of social component do you use that appeal to all generations? I agree that most find it easier to gravitate back to those early teachings especially with diet. I believe it is the life styles that people have to day. Everyone is looking for a short cut or easy way to do things. We find what is convenient and readily available. What are methods you have used to keep people motivated with healthy diets and life styles, it almost everyone needs to have a significant event from them to realize how important a healthy life style is. Is it easier to appeal to younger or older generations?

 

Jeremiah

 

 

 

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(an instructor response)

Collapse              Mark as Read    RE: Week 1         Instructor Hamilton Email this Author     3/6/2015 4:08:46 PM

I sooo agree Jemimah. My son is a physical therapist who puts out an ad in the local paper announcing “Boot Camp” he does this for teens and tweens, beginners, advanced, and seniors. He organizes a Spartan Run once a year he had 8 participants the first year, and now has almost 100 participants, he and those who finish go back and make sure everyone finishes by encouraging, assisting, etc…at the end of the day everyone crosses the finish line somehow, someway.  He usually runs his programs from April-October. For one hour and in small groups of 10 he trains them at the city park, or the high school track, and uses the town as his “gym”. What he commonly has happen after the 8 week sessions is people may or may not resign up but you will see them develop relationships and they go through the motions without his guidance….He charges $5 a person per session which lasts an hour. Determinants of Health NR 443 essay assignment discussion papers. His motto is people need to be able to pull themselves out of a hole if they fall in so he works on strength training with some cardio. He is a paramedic on the side and does B/P and Pulse checks, he also discusses a topic of the week and provides one heart healthy recipe or a smart thinking snack suggestion as a takeaway. He has a release form and is structured in his sessions. I am proud of him and his ability to make a difference.~Dr Hamilton

 

 

 

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Collapse              Mark as Read    RE: Week 1         Erica Meyerhofer Email this Author         3/6/2015 5:46:00 PM

That is wonderful.  This past summer we had a disabled police officer offer the to the children of our community a free 8 week course on speed and agility.  This was the first in our community.  I wish it would have been offered for the older adults in our community. Sometimes it just takes someone to offer to help “pull you out of a whole”.  The fitness center in our area is expensive and you must be over 15 to join. Unfortunately for our youth there is not a community center to expend energy at and if your family cannot afford to pay for you to ski, join club sports, or school sports for that matter you are just out of luck.

 

 

 

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Collapse              Mark as Read    Determinants of Health                Michelle King Email this Author  3/3/2015 6:20:18 PM

Professor Hamilton and Classmates,

 

Of the five determinants of health identified by Healthy People 2020 (2015), the one that seems to be able to have the strongest impact on all of the others is policymaking.  One clear example of pubic policy making a great impact is the tobacco tax which was a very effective incentive to decrease tobacco use in the United States.  Not only can policymaking greatly influence health by altering individual behavior, but it can also dramatically change social factors and health services.  If, in turn, for example, health services to future and expectant mothers and newborns improve, then so can we improve biology and genetics.

 

We have all seen how much the federal healthcare laws can generate widespread and far reaching change in our implementation and delivery of health care services across our nation, but other laws that are not directly related to health care can also change the health outcomes of our nation.

 

Immigration reform, for example, could have a dramatic impact on the undocumented workers pouring across our nation’s borders.  In Washington DC, the federal government’s decision not to enforce immigration laws have led to a massive number of young immigrant teens living in crowded conditions in apartments and busing into Washington to clean the offices and hotels by night.  They sleep up to 30 people in a one room apartment, and work 7 days a week, 365 days a year with no paid sick leave, no vacation, no overtime pay, no education and no future.  If they are injured or sick, they are replaced so they come to work in all levels of illness.  Many of these youth end up homeless if they do become ill.  The spread of lice, bedbugs, and even more serious illnesses such as tuberculosis is epidemic among these young paperless workers.  The number of these workers has grown to such levels that Washington DC has taken the policy decision to issue driver’s licenses to undocumented people.  The policy-making angles around this issue are endless and nurses must weigh in, because the health care needs of everyone in the United States, documented or not documented, fall to our shoulders.

 

When I think about it, it seems there really is no policy issue that is not health-related.  Certainly the looming nursing shortage is an area that all nurses should follow with great interest, and a great resource is the National League for Nursing’s website:  http://www.nln.org/publicpolicy/.

 

Michelle

 

Resources

 

Healthy People 2020. (2015).  Determinants of Health.  Accessed online at http://www.healthypeople.gov/2020/about/foundation-

 

health-measures/Determinants-of-Health

 

National League for Nursing. (2014) Public Policy Agenda: 2013-2014.  Accessed online at

 

http://www.nln.org/publicpolicy/pdf/ppagenda2013.pdf

 

 

 

 

 

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(an instructor response)

Collapse              Mark as Read    RE: Determinants of Health         Instructor Hamilton Email this Author     3/6/2015 4:36:12 PM

Great point Michelle, I believe nurses have a voice, we often see e-mails from agencies to contact our local representatives because a bill is going to the house for vote, I will be participating in political action day on March 24, this gives opportunity for health care professionals to meet legislators and show solidarity. Schools of nursing are there, professional nurses are there, and lobbyists. ~Dr Hamilton

 

 

 

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Collapse              Mark as Read    Determinants of Health                Jeremy Langley Email this Author             3/3/2015 9:06:38 PM

Dr. Hamilton and Class,

 

I feel the most important is individual behaviors and I know there are cases where an individual may have a mental or physical handicap that would prevent them from being mentally or physically active. I’m not talking about these individuals which is very low when compared to the overall population. I think as humans that we have a responsibility to take care or body and our mind and teach our children to do the same. It’s doesn’t mean that because I eat right and exercise and have a great group of friends that I won’t be diagnosed with a disease or fall ill but it does decrease my chances if I assumed the responsibility to promote my own well-being. My reaction to bad news and how I deal with the news is greatly affected by my mental health as well. If someone quits smoking or begins to exercise and eat a well-balanced diet this behavior can greatly reduce the rates of chronic disease in this country. The other 4 are important but I’ve always said that we can have the best healthcare in the world that’s free of charge but until an individual is ready to take that step toward good health and well-being then we can’t treat someone who is not ready to make the necessary changes.

 

Reference

 

http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health

 

 

 

 

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Collapse              Mark as Read    RE: Determinants of Health         Stephanie Stalter Email this Author          3/5/2015 1:07:04 PM

Jeremy,

 

you make some very good points. I agree with you that people need to take some responsibility for their own health. Sometimes, and I say this to you and not the patients, it can be incredibly frustrating that patients can be so non-compliant with their plan of care. The problem is identified, a plan is made to improve one’s health, and the patient continues the same lifestyle from which they developed these problems in the first place. Patients can be educated, medicated, and treated… but unless they are willing and committed to a lifestyle change, nothing will improve. Have you ever seen someone with an oxygen tank and a cigarette? I have. Or worse, I saw someone smoking through a tracheotomy once.  Unbelievable.  However, I must give so much credit to patients who take ownership of their health, they can be quite impressive at times. Determinants of Health NR 443 essay assignment discussion papers.

 

Very Good Post!

 

Stephanie Stalter

 

 

 

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Collapse              Mark as Read    RE: Determinants of Health         Cherry Jaudalso Email this Author             3/7/2015 1:09:02 AM

Hello Stephanie and Jeremy,

 

Wow, smoking through a trach??? You’re right, that is incredulous. Once in awhile, I get patients that come in a state of panic because they’re having a hard time breathing. As soon as we stabilize them and they feel better, they try to sneak out to smoke. I’m not really sure what goes on in these patients’ minds, smoking must be that addicting. As public health nurses, there must be something we can do to make smoking a thing in the past for these patients and for the public. I agree that every individual is responsible for their well-being, but it’s hard to quit when everybody else still smokes. Determinants of Health NR 443 essay assignment discussion papers. The other day, I met this young man with a heart disease and he had recently quit smoking. But his wife still smokes (but trying to quit) so its been very hard for him. He said some triggers give him urges to start back again, but he’s been fighting it.

 

Cherry

 

 

 

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Collapse              Mark as Read    Determinants    Mary Anderson Email this Author             3/3/2015 10:04:08 PM

Dear class,

I chose to do my topic on Barriers to access health care with the rising cost of insurance and health care cost. People still can not afford healthcare. Behavior of a person in their lifestyle also plays a role. Do they warrens risky behavior? is this a barrier to health care services? The next to this piece of the puzzle would be genetics. Though this can not be changed, we can inform others to test their family members. They can do genetic counseling. There are alot of programs out there to help combat barriers to healthcare. The biggest is the advancement of free healthcare programs and low cost prescriptions.

 

Mary

 

Determinants of Health. (n.d.). Retrieved March 4, 2015, from http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health#health services

 

 

 

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Collapse              Mark as Read    Determinants of Health                Claudia Rudd Email this Author  3/4/2015 8:31:56 AM

Dr Hamilton and Class,

The most important Determinant of Health in my opinion is Individual behavior. The old saying you can not control what others do only what you do applies here. One of the most important behaviors that individuals can do to benefit their health is hand-washing. I currently work with infection control and monitor hand hygiene in our facility. Our hands are the most common mode of transmission of infectious organisms and observing proper hand hygiene is the number one way to prevent the spread of infection. Today when you go to the grocery store most of them now have antiseptic wipes to use on the grocery cart handles. Would I love to culture one of those during flu season! Encouraging and education the public on proper hand hygiene would be a step in the right direction to controlling the spread of common cold and flu.

 

 

Reference:

http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health

 

 

 

 

 

 

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Collapse              Mark as Read    RE: Determinants of Health         Mary Anderson Email this Author             3/4/2015 3:49:19 PM

Modified:3/4/2015 3:50 PM

Dear Claudia,

 

This is often an unlooked over fact about determinants of Health. A simple hand wash is so very effective at preventing a lot of infections and spread of disease. If we as parents and families start at home teaching our kids and at school we can get them off to a great start. In the work place we can teach proper procedure and technique. Determinants of Health NR 443 essay assignment discussion papers. We can follow up on our work colleagues and hold them accountable for their actions. We post pictures of an infant or a picture of a grandma type person at work in various places and a caption on the photo might be-My life is in your hands! Or you can save a life by your hand hygiene. Skills fairs are a great way to accomplish this also.

 

 

Mary

Determinants of Health. (n.d.). Retrieved March 4, 2015, from http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health#health services

 

 

 

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Collapse              Mark as Read    Determinanta-(WK1)-Coppee    Rose Coppee Email this Author  3/4/2015 11:50:51 AM

Professor and class,

 

Health Services would be my most important determinant.  If the services are not there, people obviously won’t use them.  If there is no health coverage, the common person is not going to, or able to spend that amount of money to see a provider.  Healthy People 2020 mentions barriers to receiving health services and what these barriers can lead to.  If a person cannot receive preventable care for hypertension, it can lead to many other conditions, including death.  Hypertension is preventable, treatable, and reversible.  The community needs to take accountability for their own health to improve themselves and hopefully extend their lives.

 

Retrieved from http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health

 

 

 

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(an instructor response)

Collapse              Mark as Read    RE: Determinanta-(WK1)-Coppee            Instructor Hamilton Email this Author     3/6/2015 4:38:40 PM

Rose

You make some valid points, I would like to add there are modifiable and unmodifiable risk factors. What is important to note the unmodifiable risk factors can have less of an impact if certain behavior modifications are implemented. Thanks for sharing.~Dr Hamilton

 

 

 

 

Respond

Collapse              Mark as Read    RE: Determinanta-(WK1)-Coppee            Jemima Gutierrez Email this Author         3/7/2015 4:59:40 AM

Dr Hamilton and class,

In 1996, the Public health Services developed the Bureau of Primary Health Care to increase access to comprehensive primary and preventive health care and to improve the health status of populations defined as medically underserved (BPHC, 1996b). It is defined by Hawkins that “Medically undeserved as individuals and families who lack adequate access to primary care” (Hawkins, 1993, p. 49).Barriers to access exist such as low income, lack of health insurance, old age, poor health outcomes, inadequate health infrastructure, and insufficient supply of primary physicians, as well as cultural, attitudinal, and linguistic differences (Hawkins, 1993). Here in Florida we have health center called Primary Care Health center that offers Pediatric, Family practice, dental, Obtetrics  & gynecology and Mental health services that served the non-insured, low income and also those who has medical insurance. I was fortunate enough to serve as a Board member to this local facility in 2003 for 1 year. This health service center has a big impact into this community because of the services it offers. As a community health nurse, we can continue to discovery of ways to increase collaboration within and across various federal branches and departments that affect the availability of health professions in underserved areas. It will also help in finding ways to collaborate with churches, medical professionals into health fairs, giving fee vaccinations and teaching importance of childhood, adult vaccinations to prevent disease. Determinants of Health NR 443 essay assignment discussion papers.

 

Reference:

 

Gaston, M. H., Barrett, S. E., Johnson, T. L., & Epstein, L. G. (1998). HEALTH CARE NEEDS OF MEDICALLY UNDESERVED WOMEN OF COLOR: The Role of the Bureau of Primary Health Care. Health & Social Work, 23(2), 86-95.

 

http://web.a.ebscohost.com.ezproxy.cc.andrews.edu/ehost/detail/detail?vid=3&sid=378a12a2-a2d7-4a5e-9435-4a75e51d9e33%40sessionmgr4004&hid=4214&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#db=a9h&AN=590881

 

Hawkins, D. R., & Rosenbaum, S. (1993). Lives in the balance: The health status of America’s medically underserved populations. Washington, DC: National Association of Community Health Centers, Inc.

 

 

Jemima

 

 

 

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Collapse              Mark as Read    RE: Determinanta-(WK1)-Coppee            Rose Coppee Email this Author  3/8/2015 7:46:37 PM

 

Jemima,

 

I agree. We need more involvement in the community,…..such as you mentioned…Churches, health fairs, especially free vaccination for children. It is truly sad that we are now living in a world that parents are questioning or refusing vaccinations for children altogether. I don’t believe the community truly understands the importance of child vaccinations and the future effects of it.

 

 

 

 

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Collapse              Mark as Read    Determinants of Health                Ina James Moore Email this Author          3/4/2015 12:46:30 PM

Dr. Hamilton and class,

 

The questions that the Determinants of Health ask are what makes some people healthy and others unhealthy? Also, how can we create a society in which everyone has a change to live long, healthy lives?

 

The determinant of health that I feel is most important is health services. “Lack of access, or limited access, to health services greatly impact an individual’s health status (www.healthypeople.gov)”. I believe that this statement is 100% correct. Determinants of Health NR 443 essay assignment discussion papers. This is most important for community health because if the resources are not available for people or they are unaware of the resources that are available to them, the health of the community is going to continue to deteriorate. According to Nies & McEwen, people are more concerned with their quality of life rather than their health, but if given the resources, I believe that health could become more important to them. Working in an ER, I hear many say if these patients have Obama care, where are they still here? It is because many do not know the importance of preventive medicine or how to access it and then end up in the ER because they are requiring emergent care, thereby, increasing health care cost due to something that could’ve been effectively managed by a pcp.

 

Ina

 

Reference

 

Nies,M. & McEwen,M. (2011). Community/Public health nursing: Promoting the health of populations. Elservier:St. Louis, MI

 

http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health retrieved on March 4, 2015.

 

 

 

 

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Collapse              Mark as Read    RE: Determinants of Health         Gloria Rundle Email this Author 3/5/2015 8:36:33 PM

Ina

 

I agree that people are more concerned about quality of life and not there health. I have also seen people that would come into our clinic with there hair done nails done and designer bags and clothes complaining that they can not afford their blood pressure medication. The medication being on a $4.00 list wanting us to ” fix them”. Of course damage is done and not reversible when they have already had a stroke due to not taking there blood pressure medication and has affected their kidneys as well. Having Obama care has not been the answer for many of our patientss because alot of them refuse to use there insurance wisely and would rather get a prn pain medication filled for free than fill there insulin for free.

 

Gloria

 

 

 

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Collapse              Mark as Read    RE: Determinants of Health         Claudia Rudd Email this Author  3/7/2015 11:33:34 AM

Ina,

Access to health care is definitely something that needs to be worked on in our country. I live in a city with a large hospital/medical school facility that has a number of outlying clinics and smaller hospitals as part of the whole. However like you I see a lot of patients here that do not seek medical care until their disease process is far advanced. This is a great area in which community health nurses can help to improve the quality of health for those patients we serve.

Good post

Claudia

 

 

 

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Collapse              Mark as Read    Determinants of Health                Rachel Foreman Email this Author            3/4/2015 4:11:21 PM

According to Healthy People 2020, there are five determinants of health. The five determinants of health are policy making, social factors, health services, individual behavior, and biology/genetics. According to Healthy People 2020 “the range of personal, social, economic, and environmental factors that influence health status are known as determinants of health.”

 

The topic that I choose to discuss is health services. I decided to talk about this specific topic because I think it is extremely important. A lot of individuals do not go to the doctor until they are extremely ill or in dire need of help at that moment. I think that if more people had access to available resources or services the community (and country) would be healthier, or have the knowledge to access whenever they needed it. According to Healthy People 2020 “the lack of access, or limited access, to health services greatly impacts an individual’s health status.” There are several barriers that prevent individuals to have access to health services in their community. According to Healthy People 2020, “lack of availability, high cost, lack of insurance, and limited language access” are some of the barriers that affect why people cannot/do not utilize or have access to health services. According to Healthy People 2020, the barriers to accessing health services can lead to “unmet health needs, delays in receiving appropriate care, inability to get preventive services, and hospitalizations that could have been prevented.” if we had more available access to health services the community would be healthier and in the long run, cheaper. If we caught someone blood sugar rising, we could teach diet changes rather than treating them in the hospital from a diabetic comma.

 

Health People 2020 (2015). Determinants of Health. http://www.healthypeople.gov/2020/about/DOHAbout.aspx

 

 

 

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Collapse              Mark as Read    RE: Determinants of Health         Gloria Rundle Email this Author 3/6/2015 8:02:57 PM

Rachel

 

I agree when you state that if we had more available access to health services the community would be healthier. But I also think that teaching parents the importance of getting health care for their children at a young age and ongoing care for school age children would also help a community be healthier,

 

In Illinois I think that people that are receiving state aide should be required to attend educational programs that will help educate and provide health care for children. I have seen young mothers not have a clue on how to provide appropriate care for their children and these young mothers have more than one child.

I feel in Illinois state aide is easily obtainable and these people receiving this aide are not required to do much in order to continue to recieve this aide. I think if it was more difficult to receive aide and harder to continue to recieve this aide the more people would be more compliant to participate in their childrens and their own health.

 

Gloria

 

 

 

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Collapse              Mark as Read    RE: Determinants of Health         Rachel Foreman Email this Author            3/8/2015 7:04:17 PM

I area that I work in treats patients for the surrounding 17 counties. The majority of these counties, and primarily the ones directly connected to our county, are extremely poor, the poorest counties in Florida. The majority of our patients do not have insurance, they are on Medicare and Medicaid. Most of the children are sent home from school on the ‘backpack’ program. It is a program that the children are put on so they have food to eat on the weekend when they are home because their families cannot afford food, and they get breakfast and lunch at school during the week. With these types of situations the children are less likely to come to the doctors until their situation is to the extreme.

 

 

 

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Collapse              Mark as Read    Determinants of Health                Christina Segura Email this Author            3/4/2015 4:31:51 PM

Dr. Hamilton and Class,

 

Per the U.S. Department of Health and Human Services (HHS) initiative, Healthy People 2020, “The range of personal, social, economic, and environmental factors that influence health status are known as determinants of health” (HHS, n.d.).   These determinants are included in five categories; policymaking, social factors, health services, individual behavior, and biology and genetics. Because these categories are interrelated, interventions that target more than one are most effective (HHS, n.d.).

 

However, if I had to choose one determinant as the most important for community health, it would be social and physical determinants of health.  Social and physical determinants are highly influential in health as they impact daily lives, survivability, outlook on life, and exposures.  Examples of these determinants are education, employment opportunities, income, safety, social norms, discrimination, quality schools, transportation, and overall social and living physical environment (HHS, n.d).  These factors have a critical role in the individual’s priority of health, access to health options, and understanding of health and choices.   Financial survivability, education, safe environment (social and physical) provides the opportunity for the individual have access to health services and have growth in their individual behaviors. These factors also lend hand to better management and resources in the event of a biologic or genetic circumstance.  Education and finance also give way for policymaking influences.   “Community and public health nurses, therefore, must align themselves with public health programs that promote and preserve the health of populations by influencing sociocultural issues such as human rights, homelessness, violence, and stigma of illness. This allows nurses to be positioned to promote the health, welfare, and safety of all individuals”  (Nies & McEwen, 2011).

Think back to nursing school when we all learned about Maslow’s Hierarchy of needs.  If the basic needs of shelter, food, safety, etc aren’t being met, does the individual really care about making healthy choices?

 

Christina

 

 

Nies, M., & McEwen, M. (2011). Community/Public Health Nursing: Promoting the Health of Populations, 5th Edition. [VitalSource Bookshelf version]. Retrieved from http://online.vitalsource.com/books/978-1-4377-0860-8/id/B9781437708608000253_p1045

 

 

U.S. Department of Health and Human Services. (n.d.). Healthy People 2020: Determinants of Health. Retrieved from http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health

 

 

 

 

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(an instructor response)

Collapse              Mark as Read    RE: Determinants of Health         Instructor Hamilton Email this Author     3/5/2015 6:17:27 PM

Christina

I am wondering what you would propose or develop to empower clients in the community, is there currently a program in your area? Sometimes programs do not specifically state “empowerment” but the this is the purpose..does that make sense? Parenting classes and the YMCA are two in my area…~Dr Hamilton

 

 

 

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Collapse              Mark as Read    RE: Determinants of Health         Mary Anderson Email this Author             3/5/2015 7:07:09 PM

Dear Instructor Hamilton,

 

Christina and Class, I love the fact that nurses and community programs are working together to help the public health programs and patients.  Nurses should encourage volunteer work in the community. I have heard of visiting nurses associations.  In my research, visiting nurses associations are for nurses who want to work and volunteer in a visiting area or state. These are the programs that encourage nurses and healthcare professionals in my area: NAMRC-North Alabama Medical Reserve Corp (Healthcare professionals volunteer for public health issues and in disasters)(I am a part of this already), Red Cross, and the Free Medical Clinic (Healthcare workers volunteer). It is amazing what a few hours of your free time can accomplish. Thank you to whoever volunteers.

 

Mary

 

Volunteer Organization North Alabama Medical Reserve Corps. (n.d.). Retrieved March 6, 2015, from http://www.northalabamamrc.com/

 

VNAA – The Visiting Nurse Associations of America. (n.d.). Retrieved March 6, 2015, from http://vnaa.org/

 

 

 

 

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Collapse              Mark as Read    RE: Determinants of Health         Christina Segura Email this Author            3/6/2015 1:21:19 PM

Dr. Hamilton and Class,

Unfortunately, the area I currently live in is a small community that somewhat thrives because of its proximity and support to a military installation (the reason I live here).  As with many communities, it’s easy to identify the areas that are underserved.  Certain schools are even considered undesirable to military families that move to the area thus making certain neighborhoods prestigious and costly.  The only “empowerment” programs I have been able to locate are typically offered through local churches.  These are essentially programs offered by non-professionals, doing their best to try to provide a service to those in need because of the obvious deficit.  Local hospitals offer classes but these are typically advertised directly to their current patients.   Occasionally, I see a local OBGYN doctor offer a free seminar for mothers and daughters called “Girl Talk,” to address topics of the female body and preventative medicine.  Our YMCA only offers sports and recreation.  Local food pantries, pregnancy assistance, and cost free drug/alcohol recovery programs are all run through Church organizations.

My daughter is a member of The Beta Club and she must complete volunteer hours each month.  Because of her age, I always volunteer with her.  We often find it difficult to find organizations to assist with our volunteer time.  We often end up assisting the religious organizations’ efforts, visiting a nursing home, or a pet shelter.  There is an obvious need for structured outreach and empowerment programs in this area.

 

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Collapse              Mark as Read    Determinants of Health: Policymaking    Vanessa Machado Email this Author        3/4/2015 5:03:05 PM

Dear Professor and Classmates,

 

The range of personal, social, economic, and environmental factors that influence health status are known as determinants of health. According to Healthy People 2020, “it is the interrelationships among these factors that determine individual and population health. Because of this, interventions that target multiple determinants of health are most likely to be effective.”

 

One important determinant relates to policymaking.  According to Gnadinger, “Knowledge of the relative importance of health determinants can help design programs that prioritize interventions in areas where they are likely to have the greatest impact” (2014).  In a community, resources are limited and a community must come together to focus on what problems related to health care need addressing, and this could include areas related to social detriments of health, such as safe housing, transportation, availability of healthful foods, education opportunities, and early education programs.  Change occurs and these problems are addressed through allocation of available resources.  These resources are then distributed based on policies which are made to address each problem, with the highest ranking, first.  As Conrad and colleagues’ assert, “Very clearly focused interventions targeted to a clearly defined community population, and implemented and managed by a small number of clearly accountable organizational entities, are more likely to produce community health improvement (as cited by Gnadinger, 2014).

 

Policymaking addresses the determent of health care access as well.  The passage of the Patient Protection and Affordable Care Act (ACA) addresses population health by expanding health care coverage and  aims to improve population health by improving access to the health care delivery system, which is a critical component of a community’s population health production system (Stoto, 2013).

 

Overall, determinants of health are addressed according to a community’s major concerns, which can be related to social factors of health care access for example, but in order to address any of these determinants, a policy needs to be formed in order to address the concerns Determinants of Health NR 443 essay assignment discussion papers.

 

 

 

References:

 

Gnadinger, T. (2014). Health Policy Brief: The Relative Contribution Of Multiple Determinants To Health Outcomes. Retrieved from: http://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=123

 

Healthy People 2020. (2015).  Determinants of Health.  Retrieved from: http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health

 

Stoto,M.A. (2013). Population Health in the Affordable Care Act Era. Retrieved from: http://www.academyhealth.org/files/AH2013pophealth.pdf

 

 

 

 

 

 

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Collapse              Mark as Read    RE: Determinants of Health: Policymaking            Instructor Hamilton Email this Author                3/4/2015 7:13:13 PM

Excellent post Vanessa

Class: What are your thoughts about the public health nurse becoming politically active, do you see certain barriers and facilitators in your community…for example in my small community there is one public health nurse who also works in the school system, I can see where a conflict of interest may come into play if there is a school board issue that conflicts with a county issue…especially if grants and funding are involved.~Dr Hamilton

 

 

 

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Collapse              Mark as Read    RE: Determinants of Health: Policymaking            Jeremy Langley Email this Author                3/6/2015 5:23:18 PM

Hello Vanessa,

I think you make a great point and policymaking as it relates to health has been mostly positive. “Look at Highway Safety Act and the National Traffic and Motor Vehicle Safety Act set up by the Federal Government that helps regulate standards for motor vehicles and highways. These standards led to an increase in safety standards for cars that included seat belts, which in turn, reduced rates of injuries and deaths from motor vehicle accidents”(Healthy People 2020). I’m old enough to remember when cars were built without seat belts and almost every car bought in the 70’s and 80’s had a cigarette lighter. Most cars built today don’t even have cigarette lighters because of the changes in the tobacco policies and the taxes on tobacco products which reduced the number of people using tobacco. Determinants of Health NR 443 essay assignment discussion papers.

 

 

 

http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health#policymaking Retrieved on March 6, 2015.

 

 

 

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Collapse              Mark as Read    Determinants of Health                Kathryn Dore Email this Author  3/4/2015 5:36:18 PM

The 5 determinants of health are policy making, social factors, health services, individual behavior, biology and genetics.  I chose Individual behavior.  I think that people need to be accountable for their own health.  People can reduce their risk with cardiovascular disease by quitting or not smoking, by the foods that they eat, their exercise routines.  Any person can help themselves, by parking at the end of the parking lot and walking a further, walk stairs.  People can avoid eating fast foods, processed food, and choice healthier options.  Theses are a few things that don’t cost tons of money for people who are on a lower incomes.

 

 

Reference:

 

https://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health

 

 

 

 

 

 

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Collapse              Mark as Read    RE: Determinants of Health         Jemima Gutierrez Email this Author         3/6/2015 4:30:03 AM

Hello Dr Hamilton and class,

I agree with your rationale and there are so many thins that one can do to improve their health like walking. Individual behavior is so important because one can improve their health if lifestyle change is done. Smoking cessation,healthy eating,exercise,refraining from use of illegal drugs and alcohol consumption. As a community health nurse, encouraging policy changes inter own neighborhood in increase of use of public parking,improving sidewalks and getting local gym to have lower  fees so community people can access it. Local parks can have health fair and health teaching including lectures of health topics . It is very important for the community to be involved into their own health.

 

 

 

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Collapse              Mark as Read    RE: Determinants of Health         Ina James Moore Email this Author          3/8/2015 10:19:22 AM

Hi Kathryn,

 

Thank you for your post. I agree, individuals do have control over the choices that they make with regard to health. In addition to your suggestions, as a community health nurse, we have to show the patients what a small change in their lifestyle does for their health. Unfortunately for some people, just telling them if you walk up the stairs instead of taking the elevator could improve your health status, doesn’t work. They have to see evidence, which is where we come in. Numbers, charts, people who have gone through the same things, pamphlets, are just some of the things that have to be available as well when educating patients on the importance of what a small change in their habits can do for their life.

 

Ina

 

 

 

 

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(an instructor response)

Collapse              Mark as Read    RE: Determinants of Health         Instructor Hamilton Email this Author     3/8/2015 11:07:41 AM

Ina and Class, I agree we provide the teaching and education. Sometimes though we expect patients to be able to perform certain tasks which to them are not achievable, I remember mentioning to a gentleman who came to the office about increasing his activity provided some suggestions without really delving into in abilities/capabilities. Determinants of Health NR 443 essay assignment discussion papers. He tried the activity twice and became frustrated and stopped. The next time I saw him he told me he was doing the activity well his daughter refuted the fact and I asked him about this, he came clean and together we developed a plan which he could be successful doing. Your post reminded me of this story and the importance of sharing the abilities and capabilities.~Dr Hamilton

 

 

 

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Collapse              Mark as Read    Determinants of Health                Gloria Rundle Email this Author 3/4/2015 7:34:00 PM

There are 5 determinants of health according to Healthy People 2020. The five determinants of health are policy making, social factors, health services, individual behavior, and biology/genetics.

 

The determinant of health that I chose was Social factors. Working in a free clinic I have seen how many low income families that struggle by limited availablity of resources. Our clinic provided alot of resources o help our patients get to the clinic especially families with children. We provided cab vouchers or bus passes for transportation as well as medications or sample medications for patients struggling to get medications due to no insurance or no income to afford medications.

 

Now with the Affordable Care Act in place people are still struggling to afford medications and other services that were once provided by our clinic. The Affordable Care Act was a good attempt to help provide insurance for everyone but alot of people are still struggling to afford medications and copays for services they are needing. Alot are struggling due to a lack of knowledge and unable to understand how insurance works and what is covered and what is not covered.

 

Our clinic did provide education to help patients better understand their conditions. We helped patients to access services needed for their conditions

 

 

 

Reference:

http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health#social

 

 

 

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(an instructor response)

Collapse              Mark as Read    RE: Determinants of Health         Instructor Hamilton Email this Author     3/5/2015 6:21:17 PM

Good topic Gloria! Last fall on the news an issue pertaining to school children not having services to prepare them for school and parents needing to choose between access and cost…I wondered with the state of the economy if this is seen more now than ever…how much is this truly in their control…someone forwarded this to me in a previous course, the schools in my area became influxed with issues pertaining to children who were in desperate need of school physicals, immunizations, and dental services…we had tried to secure volunteer services but the major concern is ongoing and not just this year…what is our long range plan…this is the question…as well as where is our funding going to come from…thanks for the post~Dr Hamilton

School Context as Social Determinants.pdf

 

 

 

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Collapse              Mark as Read    Determinants of Health                Pamela Mintz Email this Author 3/4/2015 7:57:22 PM

Class & Dr. Hamilton –

 

I personally feel that Individual Behavior is the most important, but I noticed this was already discussed about by a large number of classmates, so I will discuss the social factors (social and physical determinants). I feel this is another very important category as well. Determinants of Health NR 443 essay assignment discussion papers.

 

“Even in the most affluent countries, people who are less well-off have substantially shorter life expectancies and more illnesses than the rich. Not only are these difference in health an important social injustice, they have also drawn scientific attention to some of the most powerful determinants of health standards in modern societies” (Marmot & Wilkinson, 2003, p. 7). Marmot & Wilkinson (2003) went on to describe some of the research methods used as evidence to back this up – some data even followed thousands of people over decades, through their socio-economic status versus their health and wellness.

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Looking at Healthy People’s website, some of the social determinants included things such as exposure to crime, violence, and social disorder, such as the presence of trash, public safety, and availability of resources to meet daily needs (Healthy People, 2015). Think of child #1 who maybe lives in a “slum” part of town, is exposed to gang violence, drug selling and using while he walks down the street, and an abusive boyfriend that hits his mother and yells at the child. Then consider child #2 who say only has a single parent, but lives in maybe a middle class suburban home, with freshly manicured yards and friendly neighbors, with children riding their bicycles up and down the street. Knowing how stress levels can impact one’s health, both mentally and physically, think of these two children. One would assume child #1 deals with a higher level of stress than child #2, and maybe could have some emotional problems in regards to authority figures.

 

Looking at physical determinants, things are mentioned such as exposure to toxic substances and other physical hazards, and natural environment, such as plants, weather, or climate change (Healthy People, 2015). An adult in Alaska may have different physical ailments than if he lived year round in Florida. Determinants of Health NR 443 essay assignment discussion papers. Even something such as allergies, which I can attest to first hand, are varied depending on the environment. Using my brother as an example (who has severe allergies to both foods and environmental allergens): when moved to Florida for college for a few years, his Ohio allergies almost completely vanished. His breathing was amazing and he could stop his medication.

 

Although Individual Behavior is very important (like the saying goes, “you are what you eat”), I believe that social and physical determinants play a huge role in health. Many of these social and physical determinants cannot be easily changed, or individuals may not have full control over.

 

 

Pam

 

 

References

 

Healthy People. (2015). Determinants of Health. Retrieved from http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health#social

 

Marmot, M. & Wilkinson, R. (2003). Social Determinants of Health: The Solid Facts (2nd ed.). Copenhagen, Denmark: World Health Organization Determinants of Health NR 443 essay assignment discussion papers