Social determinants of health refer to social and economic factors that specific individuals have to deal with because of birth, status, gender, culture, race, income status, employment, physical surroundings and access to health services (Government of Canada – modified 2019).These determinants influence the behavioural and risk factors of individuals within specific geographical neighbourhoods.

     Low income and culture are two of the many risk factors for diseases. Because of the lack of proper education, there is lack of knowledge that is essential to promote and prevent diseases and restore health. Culture plays a role because of traditions, customs and beliefs, the family may not think, act or feel the same way about their overall health.

    The communicable disease chain model is a means of addressing the different transmissions that happens when the agent leaves it host (reservoir – human or animal or the environment such as mosquitos in stagnant water, poor air quality) through a portal exit and enters via transmission through a portal entry to infect a susceptible host. “Th emode of transmission is th emeans of the agent’s travel from the portal of exit to the host” (Green, 2018). This sequence is usually referred to as a chain of infection. If there is a break in the chain of infection, then it is aborted.  For a community that is already at risk because of social determinants of health it is important that diseases are addressed promptly to avoid the widespread infection. For example, in a nursing home where there are less workers and many patients, a staphylococcus bacterium, such as methicillin-resistant Staphylococcus aureus (MRSA) can be passed easily via a source to a susceptible host. In order to avoid this transmission, proper handwashing is necessary before and after patient care to abort or prevent this chain of infection.

References

 

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3 postsRe: Topic 2 DQ 2

“Global health plays an increasingly crucial role in both global security and the security of the U.S. population (Office of Disease Prevention and Health Promotion, 2019)”. The health in our communities or in the United States population could possibly be affected by events around the world. For example, there is more access to easily visit many countries throughout the globe. Many individuals enjoy travelling and explore countries which they may not be aware a health threat or epidemic is developing. It is often heard or written in the news of infectious diseases are emerging and causing a threat. “The Institute of Medicine’s 2003 report Microbial Threats to Health2 stresses that the United States should enhance the global capacity for responding to infectious disease threats and should take a leadership role in promoting a comprehensive, global, real-time infectious disease surveillance system (Office of Disease Prevention and Health Promotion, 2019)”.

Website, https://www.intrahealth.org/vital/10-global-health-issues-watch-2019, lists ten global health issues to watch in 2019. Unbelievably one that hits close to most of our communities is food related. Across the globe, there is high demand for high calorie and low to no nutritional value diets that are being combine with a sedentary lifestyle which increases the probability of heart disease, diabetes and noncommunicable diseases (NCDs).“NCDs are now responsible for around 41 million deaths per year, according to the World Health Organization—and more than 85% of those occur in low- and middle-income countries (IntraHealth International, INC., 2019)”. This affects everyone, even impacts larger health care systems. “NCDs are estimated to cause a cumulative loss of output of $47 trillion between 2011 and 2030 (Kaoser Family Foundation, 2019)”.

The health care stakeholders have been aware of the emerging global health issue, it is alarming because many of the non-communicable diseases may be prevented all with proper nutrition and adding more activity in the individual’s routine. The health care delivery systems have a system where the goals are to promote health, prevent the disease, and protect the population’s health. My example was regarding nutrition, stake holders may encourage fast food restaurants to serve healthier alternatives as equally affordable as the high fat cheap take outs. In regard to activity, insurances may offer discounts for gym memberships or online virtual classes that may be done in the comfort of their home. These suggestions will not take a toll on their budget compare to a person acquiring an NCD and accruing clinical or hospital bills. The investment in providing proper education is necessary and the process ought to be aim globally.

 

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3 postsRe: Topic 2 DQ 2

A recent global health issue to affect many different world populations is Ebola. It has made news in the last few years due to multiple outbreaks. The Ebolavirus is part of the Filoviridae family and has six different species within its own categories. The most common for current outbreaks and infections is the Zaire strain (CDC n.d.). The incubation period spans from 2 days to 21 days in the susceptible host. It is transmitted via direct contact with infected bodily fluids and items contaminated with those secretions. Fatality rate for those infected is up to 50 percent, but early diagnosis and supportive treatment increases the odds of survival (CDC n.d.).

It is believed that the original host of the Ebolavirus is the fruit bat but can also be traced to other wild animals such as fruit flies, porcupines, and primates. The early signs/symptoms include fever, fatigue, muscle aches and pains, headache and sore throat. These symptoms often make it difficulty to distinguish the exact viral infection because many viruses mirror the same symptoms. These initial symptoms are followed by more intense vomiting, diarrhea, impaired kidney and liver functions, internal and external bleeding, decreased WBC and platelets, and increased liver enzymes. Hosts of the virus can only spread the infection when they have the active symptoms, therefore cannot spread infection during the incubation period. Exact diagnosis is done through several blood tests including the ELISA test, antigen-capture detection test, serum neutralization test, electron microscopy, and virus isolation by cell culture (CDC n.d.)

International monitoring of the Ebolavirus is done by the World Health Organization (WHO), under the United Nations. The WHO is considered to be the guardians of public health and security internationally and they are actively involved in setting up preventative and reactive programs/education. These programs are designed to decrease the possibility of an outbreak in any given population (GCU 2018). The response by WHO to the Ebolavirus outbreaks include supporting local and state health departments in disease detection, tracing the source of the outbreak, laboratory services, controlling the infection spread and instituting safe burial practices to prevent the spread of the virus (CDC n.d.). Preventative services by WHO include education on all levels to prevent outbreaks and attempts to break the chain of infection (CDC n.d.)

References

Centers for Disease Control and Prevention. (n.d.). Retrieved October 3, 2019, from https://www.cdc.gov/.

Grand Canyon University (Ed). (2018). Community & public health: The future of health care. Retrieved from https://lc.gcumedia.com/nrs427vn/community-and-public-health-the-future-of-health-care/v1.1/

 

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1 postsRe: Topic 3 DQ 1

A group is considered as a “vulnerable population” if it has continuing or more aggravating factors that maintains their poor health status compared to an “at- risk” group. There is a significant disproportionate risk of poor health outcomes for vulnerable populations which would include those living in poverty, homeless, disabled, severe cognitive impairment or extremes of age (Maurer & Smith, 2013, p.527). While at risk groups have a chance of being affected, the vulnerable group has many variables that attribute to the susceptibility of poor health. “A vulnerable population is more likely to develop health-related problems, have more difficulty accessing health care” (Maurer & Smith, 2013, p. 528). Vulnerable groups are “more likely to experience a poor outcome or shorter life span because of those health conditions” (Maurer & Smith, 2013, p. 528).

For example, a person is considered vulnerable if he/she suffers from a disease, but also has an income below the poverty level, no health insurance, and stressors related to their living conditions, such as homeless people (Maurer and Smith, 2013).

One example of vulnerable population group in The United States is the children who lives in poverty or parent has very low income to satisfy their necessities. It is estimated that about 387 million children worldwide live in extreme poverty wherein the household income is estimated to be around less than 2 dollars per day. Worldwide, about 19.5% of children compared to only 9.2% of adults are in extreme poverty (UNICEF, 2013). In the United States, poverty is an increasing problem such as from 2009 to 2010, there is almost a 1 million increase of children living in poverty. Child poverty has many effects on the child such as inadequate nutrition, poor academic performance, lack of health care insurance behavioral, social and emotional problems which also makes them further at risk for abuse and/or neglect (American Psychological Association, 2018).

Nurses may need to help advocate for these very young children who live in poverty by helping provide them knowledge and access to appropriate health care and nutritional services. This entails being familiar with existing laws that helps protect their rights and knowledge of existing services that they are eligible to receive (Maurer & Smith, 2013, p.151). Aside from providing health promotion and education, nurses help further by educating vulnerable families on how to access available resources and referral to social services. According to United States Department of Agriculture Food and Nutrition Service (2018), there are several federal programs which help provide nutrition assistance such as Women, Infants, and Children (WIC).

Children from low-income families are most vulnerable of suffering from consuming empty calories. One ethical issue is the involvement of the government in improving school lunches being provided in schools which is being aimed at combating obesity and malnutrition. In 2010, the Hunger-Free Kids Act mandates improving school lunches to provide nutritious foods as recommended by the federal dietary guidelines. This involves increasing fruits, vegetables, non-fat milk and whole grains while decreasing high fat, salt and sugary foods. This bring about the ethical issue of not allowing children to choose the foods they prefer to consume (Crawford, Gosliner & Kayman, 2011). This appears to be a good initiative from the government to implement healthy school meals to ensure that children, especially those from low-income families, are able to meet the recommended nutritional requirement to prevent malnutrition and the possible long-term health problems associated with it. It may be important that nurses also help educate families on the importance of having a nutritious diet and avoid consuming empty calories which may lead to obesity and health problems.nurses also help to educate families on the importance of having a nutritious diet and avoid consuming empty calories which may lead to obesity and health problems.

“Community health nurses can advocate on the behalf of vulnerable groups by writing and calling government representatives and speaking to professional and community organizations about the problems and needs of high-risk groups” (Maurer and Smith, 2013).

 

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1 postsRe: Topic 3 DQ 2

The nurse recognizes bias, stereotypes, and implicit bias within the community by spending time in the community and getting to know the individuals of that community.The nurse can do this by performing a community/public health assessment.During this assessment the nurse can learn and gain knowledge about the individuals’ in the community’s social, environmental, and cultural needs which must be addressed within this process as well (Community and Public Health:The Future of Health Care, 2018).

An implicit bias is not only harmful because it is undeserved, but it can also lead to disparities in care. Even if you are unaware of how you are feeling, your body language, your focused attention, and your level of care can be impacted directly by the way you are feeling. Each patient deserves your full care, so understanding what might trigger you to act differently will make you a better nurse. One can start by knowing their patients, understanding cultural differences can also help you become aware of any unconscious bias and begin to overcome it.

Cultural competence can be defined as “developing an awareness of one’s own existence, sensations, thoughts, and environment without letting it have an undue influence on those from other backgrounds; demonstrating knowledge and understanding of the client’s culture; accepting and respecting cultural differences; adapting care to be congruent with the client’s culture,” (Neese, 2017).A nurse should address these concepts of bias, stereotypes, and implicit bias to ensure health promotion activities are culturally competent showing cultural awareness, cultural knowledge, cultural skill, having cultural encounters, and having cultural desire (Neese, 2017).These five elements describe the Campinha Bacote cultural framework model. This model is regarded as a prominent guide for cultural competence in nursing and may occur in the process of becoming culturally competent (Community and Public Health:The Future of Health Care, 2018).

As a nurse the strategies I can use to reduce bias is notice my assumptions and understand what assumptions trigger me. Get to know my patient by talking to them. “Understanding cultural differences can also help you become aware of any unconscious bias and begin to overcome it” (Quinn-Szcesuil, 2018). “The Minority Nurse” is a magazine and a website that focuses on minorities in health care. The magazine and website have different articles on cultural competencies. A nurse can go to https://minoritynurse.com to research articles about cultural competencies.

 

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