APPLICATION OF COMMUNITY HEALTH & POPULATION-FOCUSED NURSING
Solution for Part C
Community Health Diagnosis
The social, economic, and environmental environment in which individuals live greatly determine their health outcomes. As such, it is important for the health care system to be well aware of the community level health determinants to appropriately address them in view of improving the health status of the community. Austin has covered great strides in terms of its health system not just at the hospital level, but also at the community level. However, there are still various concerns about the social and economic environments that have a negative impact on the health status of the community. Results from the Texas State records and the national records’ archives coupled with Focused group discussions, observations, and community forums were used in a comprehensive community health assessment process. The assessment was intended at identifying the various social, economic, political, and environmental factors that may have an influence on the health status of the community and identifying how much impact such factors have and the efforts that have been put in place towards ensuring that such factors are positively influenced. This paper is going to establish a diagnosis of the community with a reference to the three major problems faced by the community as identified through the assessment. The paper will then narrow down to one of the problems and discuss the various resources that are available in the community to address the problem.
C. 1. Major community problems
One of the major problems identified through the community health assessment of Austin/Travis County was the emphasis placed by the health organs on treatment of health problems as opposed to prevention (Planning and Zoning Department, 2014). This is contrary to one of the Healthy People 2020 goals that is aimed at promoting healthy development, quality of life, and healthy behavior (Healthy People, 2015). Both the local government and other relevant parties overlook the social cues within the community that determine the health status of individuals and thus fail to establish mechanisms through which such cues can be manipulated towards ensuring that related health problems were averted. No proper warning and prediction mechanisms were in place to review the health status of the community and to facilitate establishment of countermeasures that would ensure that the health issues were proactively dealt with at the community level. It is clear that if the relevant authorities focused on addressing social influences of health and implementing efforts at population level, then most conditions would be delayed or prevented, an aspect that would in turn ease the health cost on the region and specifically on the health care system. Coordinated behavioral health care was considered a critical factor that ought to be tackled through preventative measures in order to avert any behavior related devastating health outcomes. Integration of mental health care into primary care and providing the residents with wrap-round services including employment and housing all encompass coordinated care, which is a key preventative approach that if embraced would improve Austin’s community health status. Another aspect that is important to coordinated care and was noted as missing during the assessment involves proper exchanging of information and sharing of data through the use of electronic health records. Continued reliance of most of the health organizations within Travis on the traditional methods of information storage and keeping have contributed to the continued slag movement of the region in terms of the quality of health care. It is also important for funders to tie their funds to coordinated care and to insist on integrated care in order to reduce the current competition among health institutions and patients for limited resources.
A second major problem of concern in Austin/Travis County is the lack of equity in terms of access to health care, which is contrary to the Healthy People 2020 goal of achieving health equity, improving health for all the individuals, and eliminating disparities (Healthy People, 2015). Some of the focus group participants raised concerns over the difficulties faced by some of the members of the community in accessing health services. One of the participants insisted that health services should be treated as a haircut, routine and easy to get. Most of the residents proposed the established of more community-based clinics that are centrally located to allow for increased accessibility of health care services. Some of the participants in the focus groups also showed their frustrations with the limited capability of the health facilities when it came to providing patients with services that are both linguistically and culturally appropriate. Most of the health professionals lack knowledge of the available resources that can be used for this purpose. Most of the residents also raised various concerns through the community forum concerning their limited education and information that has hampered their awareness of the available community resources, an aspect that has made it a difficult task to navigate the healthcare system, which remains to be highly complex. One of the focus group participants suggested that there are a lot of resources within the community, which most of the people remain unaware of and thus do not access these resources. According to some of the participants, bringing a medical school or teaching hospital to Austin would be an important step in ensuring health equity. On the other hand, a member of the community in the community forum shared that individuals with mental health conditions and the disadvantaged community would highly benefit from a teaching hospital. Nevertheless, a majority of the participants noted the importance of securing more funds to facilitate the affordability of health care and to increase insurance coverage.
The third problem that was reported among Travis County residents as a major hindrance to health care access was the issue of the cost of health care and health insurance, which contradicts the Healthy People 2020 goal aimed at creating a physical and social environment that would ensure good health for all (Healthy People, 2015). As one of the focus group participants mentioned, the residents are required to pay a co-pay and a monthly annual deductible one that most individuals cannot afford and thus are less likely to visit a doctor even when they need to. The cost of insurance, prescriptions, and co-payments was also termed by the community forum participants as too high. Most of the focus group participants cited underinsurance and the lack of insurance as the major barrier to health care accessibility. Most of the participants in the focus groups expressed their fear of utilizing the health care system as the cost was unexpected, especially in cases where one fails to qualify for public assistance such as Medical Access or Medicare program. Individuals also noted their resolution to self-care as public assistance programs offered limited services. For instance, such programs do not offer dental services. Due to the unaffordability of health care, a majority of the population in Austin cannot access health services, an aspect that could explain the high rate of death due to manageable conditions.
C. 2. High healthcare cost and available community resources
It is clear that the most significant problem facing residents of Austin in terms of their HealthCare system is the high cost of health care and health insurance (Planning and Zoning Department, 2014). As such, this forms a highly important area that requires exploration and development of an understanding of the various factors that contribute to such a high cost of health care. Most of the residents are shut out from accessibility of health care services and resolve to other ways of upholding their health care, including self-care. It is important to note that in order to address this problem, various resources across the social and economic fronts must be tapped into. To start with, various public assistance programs already exist within the county, with the only impediment to accessibility of this programs being the tough qualification requirements. One of the participants argued that the qualification requirements must have been established to ensure that the largest number of individuals are locked out. It is important for the public assistance programs such as Medicaid and Medicare as well as Medical Access Program to receive more funding and proper strategic management to allow for coverage of a larger part of the population who are not able to access medical services. Tough restrictions such as those barring individuals without insurance policies from accessing these services lock out those individuals who cannot affirm even such policies. It is also important for social and economic issues such as unemployment to be addressed in order to ensure that a large part of the community are able to afford health care. Such would be facilitated by introduction of cheaper health packages and introduction of insurance regulations that would ensure that low income individuals are well catered for in the insurance policies. The public health department should also allocate funds for establishment of community based clinics that would ensure that the high demand of health care services is met as this would ensure that other sources of health care services such as the private organizations also reduce the cost of their health care services.
C. 3. Primary prevention topic
Topic: Low healthcare insurance
The most efficient way of reducing the high cost of healthcare and the resultant reduced level of access of health care services in to allow for reduced cost of insurance coverage for the residents. It is important to note that the society is well distributed in terms of household income and thus ranges from high income to low income households. With such a factor, it is important for all the income categories to be provided for with opportunities to seek insurance. As such the low income individuals should be offered cheaper insurance packages that would be complimented with the public assistance programs such as MAP, Medicare, and Medicaid. Low healthcare insurance costs can be achieved through increasing the healthcare resource base and the number of facilities to match the demand for healthcare I the region as this would reduce demand and hence cost.
It is clear that healthcare is an issue of
great importance to Austin/Travis County, with the community health assessment
revealing that the social, economic, political, environmental factors have a
role to play in the health care, especially in accessibility of health care
services. Residents of Travis County have experienced reduced accessibility to health
care services due to the increased population and high cost of health services
and healthcare insurance, an aspect that has locked out most low income
individuals. By reducing the cost of healthcare insurance, the region would be
able to address the issue of equity in healthcare accessibility and thus
facilitate improved community health status.
Healthy People. (2015). Healthy People 2020. Retrieved from Healthy People: https://www.healthypeople.gov/sites/default/files/HP2020_brochure_with_LHI_508_FNL.pdf
Planning and Zoning Department. (2014). Demographic Data. Retrieved from AustininTexas.gov: http://www.austintexas.gov/page/demographic-data
Appendix A: Questions for the Community Forum
- My health would be better if…
- What are the most significant problems in the community?
- What resources or services within the community determine the health of your family?
- What other services does your family need?
- What does it mean for a community to be healthy to you?
Appendix B: Focus group sectors
Mental and Behavioral Health