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Nursing

Community Health Assessment and Action Plan

Introduction

The establishment of a successful community-based intervention plan for heart disease is a critical component of ongoing efforts to promote health and wellbeing for local residents who face these risks. It is necessary for communities to identify the challenges associated with health promotion and assessment that currently exist in order to support new objectives and considerations that will accomplish the desired objectives. There are critical needs within communities that must be addressed through the development of action plans that will be implemented by professionals to facilitate improved compliance with specific objectives related to heart disease. In Baltimore, Maryland, heart disease is a common phenomenon that requires further assessment and evaluation so that local residents are provided with preventative tools and measures to improve their own health and restore their vitality and wellbeing. The following discussion will consider the community of Baltimore and its current health needs and will identify an action plan that will provide greater support for this population and their needs as related to heart disease.

Health Assessment

            Baltimore, MD is a large metropolitan community that faces similar health risks to other communities with respect to heart disease and related conditions. It is important to identify the specific population groups that are most affected by this condition and to determine how to best approach disease management in order to facilitate optimal outcomes for this community. The City of Baltimore faces a great risk of heart disease that is not that unique from other communities; however, Baltimore has its own set of population demographics that must be properly identified and addressed so that the proposed action plan will be most effective for this community. Therefore, nurses and other healthcare professionals must take the steps that are necessary to create an action plan that will target this community and provide the necessary benefits as effectively as possible. An effective community-based assessment is critical to the success of a given strategic approach to improve public health initiatives and wellbeing (Williams, 2009; Walker et.al, 2011). Health assessments also require an analysis of specific populations in order to improve health promotion activities across these groups (Harris-Roxas and Harris, 2011).

From an environmental perspective, it is important to identify specific indicators that may impact health assessments and promotion activities within communities (Collins and Koplan, 2009). Team-based activities are critical during the assessment process and support the expansion of activities for a given purpose (Elder and Paul), while also considering the impact of these activities in the team setting (U.S. Office of Personnel Management). Perhaps one area to consider is specific needs assessments for elderly persons versus younger age groups, with the former more likely to require advanced directives due to age and other factors (Taylor, 2012). Miller (2005) demonstrates that communication within a given setting is critical to the success of a healthcare directive and should be utilized in team settings to facilitate positive outcomes. Furthermore, collaborative efforts in a community-based setting should signify a commitment to the initiative and the people that it serves through effective communication channels, rather than weak ones (Kvarnstrom, 2008; Coeling and Cukr, 2000). Laverack (2006) encourages community empowerment through the development of specific initiatives that are designed to promote health and wellbeing. A successful example is the Kaiser Permanente Community Health Initiative, which has been effective in providing tools to local residents who otherwise might not have access (Cheadle et.al, 2010). Some community members may possess specific beliefs regarding therapies that may support improved health, but these are not always easily understood, including the use of alternative therapies to treat chronic illnesses (Fennell et.al, 2009; Hassan et.al, 2010; Ndao-Brumblay and Green, 2010).

For the City of Baltimore, approximately 200 deaths occur per 100,000 members of the population resulting from coronary artery disease, which is well above the state average (Maryland Department of Health & Mental Hygiene, 2009). Therefore, it is strongly evident that many residents in Baltimore who face a greater risk of heart disease may not recognize this risk or are not taking the steps that are necessary to improve and maintain their own health (Maryland Department of Health & Mental Hygiene, 2009). In particular, African Americans face the greatest risk as a result of this condition and their needs must be addressed as a key component of a larger community-based effort to promote heart health and wellbeing, including the reduction of obesity rates within this population group (Johns Hopkins Urban Health Institute).

According to the Baltimore City Health Department, ‚ÄúBaltimore, home to 637,455 people, is located in the wealthiest state in the nation, yet has nearly 20% of its residents living in poverty. Many of these are the working poor who cannot afford health insurance and who are frequent, but inefficient users of the healthcare system‚ÄĚ (Baltimore City Health Department, 2009, p. 4). Under these conditions, it is important to identify the specific factors that play a critical role in the continued growth of the heart disease epidemic within Baltimore, given that poverty impacts approximately one-fifth of the City‚Äôs population (Baltimore City Health Department, 2009). Under these circumstances, outreach and prevention are difficult to accomplish when this population group do not have access to health insurance and services at all, or this access is severely limited (Baltimore City Health Department, 2009). These findings suggest that it is necessary to identify specific indicators that may reduce the risk of heart disease within this population through the development of an action plan that will address these concerns in a comprehensive manner to improve overall awareness of heart disease and the risks associated with this condition throughout the City of Baltimore.

Action Plan

¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬† An action plan to reduce the risk of heart disease for Baltimore residents requires an effective understanding of the specific risks and challenges of this group and their level of understanding of this condition and how it impacts their daily lives. Some of the most important factors to consider include the following: ‚ÄúCardiovascular disease behavioral risk factors include: inadequate physical activity and exercise, poor dietary habits, tobacco abuse and excessive alcohol intake. Community-based approaches seek to understand and address aspects of the socio-cultural environments that impact behavioral risk factors. Using the affected communities as the setting for intervention allows increased awareness and better understanding of the barriers and facilitators to behavior change‚ÄĚ (Baltimore City Health Department, 2009, p. 9). These circumstances coincide with the lack of understanding of the specific factors that contribute to negative outcomes for this population and the challenges that they face, either without any form or health insurance or very limited coverage, both of which may lead to considerable consequences for their health and wellbeing (Baltimore City Health Department, 2009). Under these conditions, it is important to identify the specific factors that are represented by these phenomena in order to determine how to best move forward with action plan that is most appropriate for the needs of this population (Baltimore City Health Department, 2009).

The utilization of local community-based services and principles is essential to the discovery of new perspectives and strategies to improve the cardiovascular health and wellbeing of Baltimore’s population. This is challenging because it requires an effective understanding of the limitations placed on residents due to their lack of knowledge and experience with cardiovascular disease and how it impacts their health in different ways. It is likely that a lack of knowledge regarding diet, nutrition, physical activity, tobacco use, and alcohol consumption are key contributors to the elevated risk of heart disease within this community (Baltimore City Health Department, 2009). Therefore, it is recommended that there must be additional factors in place that will promote a successful action plan for widespread implementation throughout this community (Baltimore City Health Department, 2009).

Baltimore‚Äôs population faces risks that are not that different from other communities with respect to heart disease. Therefore, lessons learned across other populations might be useful in developing a strategy for this community and its people. The action plan that is chosen for implementation must consider the following key areas of development: long-term impact, the capacity for continuous development and expansion, improving policy, moving forward with an action strategy, and expanding collaborations with other communities (CDC). It is known that ‚ÄúThe economic costs of heart disease and stroke rise each year. These costs include the numbers of people requiring treatment for risk factors or early signs of disease; emergency treatment for first or recurrent episodes of heart attack, heart failure, or stroke; and efforts to reduce disability and prevent recurrent episodes‚ÄĚ (CDC, p. 4). These findings suggest that it is more important than ever to develop strategic approaches that will facilitate the support of new ideas and community-based initiatives to encourage cardiovascular disease prevention as best as possible for Baltimore residents (CDC).

The impact of a strategic action plan to reduce the risk of heart disease also requires an effective understanding of the risks associated with this condition. Behaviors are perhaps the key to understanding how individuals respond to heart disease and in establishing its overall impact on health and wellbeing for a given community. In Baltimore, this appears to be particularly relevant because lifestyle behaviors for many members of the affected population lead to greater risks, including poor dietary consumption, smoking, excessive sodium intake, and limited physical activity, amongst others. Under these conditions, it is important to identify the specific areas where behavioral improvements might occur so that cardiovascular disease risk is significantly reduced.

An action plan to reduce heart disease risk for Baltimore residents requires a detailed assessment of the population and its current lifestyle behaviors because this practice will facilitate the development of new ideas to promote positive lifestyle behavioral changes for the residents of Baltimore. Due to the costs of prevention programs and their limited impact in many cases, it is necessary to identify the specific factors that are relatively easy to measure and that might have a greater and lasting impact on the community at large. These efforts will demonstrate the importance of specific factors that will support long-term behavioral and lifestyle changes within this population.

From a public-based perspective, the development of a strategic approach to reduce the risks associated with heart disease requires public support and intervention not only through financial means, but also through the utilization of knowledge and experience that is present within the Baltimore community. This coincides with national public initiatives to improve health and promote awareness of heart disease and other conditions that impact communities throughout the United States. These factors play an important role in reducing these risks and in enabling community residents to better understand how their own behaviors impact their health and wellbeing in different ways. This is an important step towards the discovery of new insights and approaches that will positively influence outcomes for these residents.

Public health initiatives and other challenges must evolve so that there are significant opportunities for growth and development within communities such as Baltimore. In particular, this community faces significant racial disparities and such factors as low education levels and low incomes that may prohibit access to routine healthcare services (Shaya et.al, 2006). In addition, ‚ÄúPeople with lower socioeconomic status (SES) are more likely to be uninsured, have low-quality heath care, and seek health care less often; when they do seek care, the problem is more likely to be an emergency‚ÄĚ (Shaya et.al, 2006, p. 140). Under these conditions, it is expected that there will be significant problems that continue over time that must be addressed through action plan efforts so that local residents will benefit from these initiatives and will improve their own cardiovascular health by utilizing these offerings (Shaya et.al, 2006).

Establishing an effective action plan for the Baltimore community also requires an effective screening tool that will be utilized on a regular basis within the community to support long-term growth and wellbeing for this population, and in particular, African Americans (Shaya et.al, 2006). These efforts must coincide with other strategies in place within the community and should also reflect a means of expanding knowledge and growth of specific factors associated with community-based support of these offerings (Shaya et.al, 2006). From a behavioral perspective, enabling this community to recognize the benefits of positive behavioral changes may make an important difference in their ability to remain compliant in these endeavors (Shaya et.al, 2006). These creative approaches must demonstrate the importance of specific interventions and other factors that are instrumental in shaping outcomes for this group of residents (Shaya et.al, 2006).

From a compliance-based perspective, the ability of local residents to accomplish the objectives of the action plan requires a continuous effort from social service and healthcare providers to motivate residents so that they are able to reduce their risk of cardiovascular disease over time. This is an important and meaningful accomplishment for the community and requires a greater understanding of the different challenges and limitations that exist in supporting the development of new ideas and approaches to facilitate improvements not only in lifestyle behaviors, but also in the ability to access specific healthcare services within the community setting. This is a critical offering that must be provided through the efforts made with the action plan and should be effective in supporting the development of new ideas and approaches to encourage growth and change within the members of this community, and in particular, those who face the highest risk of cardiovascular disease. With these steps in mind, local residents are likely to experience greater benefits and will be empowered to improve their health and wellbeing through specific lifestyle changes and behavioral modifications to accomplish these efforts in an effective manner.

Key community organizations and professionals, such as nurses, social workers, pharmacists, churches, hospitals, clinics, schools, and others must identify areas where collaboration might be beneficial in supporting the long-term growth and sustainability of the chosen action plan. It is necessary to identify specific factors that are associated with positive outcomes for local residents that also address disparities in healthcare access, screening, and treatment for this population group. With these efforts in mind, it is necessary to also address methods of developing and sustaining an action plan that is cost effective and appropriate for the population in question and the needs of the local community at large. These efforts will provide significant and meaningful benefits to local residents in their efforts to achieve positive health outcomes for the foreseeable future. Since the risk of cardiovascular disease is significant for many residents of Baltimore, it is more important than ever to address these disparities and to consider the challenges of creating an environment that supports these objectives and developments over the long term.

Conclusion

The people of Baltimore face significant risks associated with cardiovascular disease and its impact on their lives. In particular, African Americans face a significant risk of cardiovascular disease due to various disparities within the culture itself and in obtaining routine access to quality healthcare services. It is important to identify these risks and to take the steps that are necessary to support new ideas and approaches to this condition and to minimize these risks as much as possible. Community-based initiatives must be established to expand knowledge and awareness of heart disease and its overall impact on local community residents. It is important for local community members with experience in public health and social services to participate in these endeavors to ensure that local residents are taking the steps that are necessary to improve their health and to minimize their risk of cardiovascular disease. Therefore, greater access to healthcare services must be achieved to improve lifestyle behaviors, screening mechanisms, and other factors that are active contributors to the reduction of risk associated with cardiovascular disease within this community. Finally, it is important for local organizations and professionals to identify areas where disparities exist and to address those disparities as directly as possible to reduce the long-term impact of heart disease on the community as a whole. These efforts will demonstrate the importance of specific factors and approaches that will facilitate greater outcomes and that will utilize specific community-based knowledge and experience to develop efforts to improve outcomes for local community members that will be consistent and routine over time.

 

References

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