DNP 825 TOPIC 8 DQ 1

DNP 825 TOPIC 8 DQ 1

Compare prominent health concerns in developed countries with prominent health concerns in underdeveloped countries, and explain how factors such as the economy, politics, and natural resources contribute to global health disparities. What can you do as a DNP-educated nurse to help reduce these global health disparities? Provide examples and relevant literature to support your response.

Healthcare is now moving from the category of factors that determine the well-being of each person to the type of conditions necessary for the full successful development of the state. There are central health concerns in developed countries, such as healthcare system expenditure. In underdeveloped nations, they include mortality and infections; the main political, economic, and other factors influence the situation. In comparison, around ten million people in underdeveloped countries suffer and die from diseases that can be prevented or treated quickly, including malaria, HIV, and tuberculosis (Wiblin, 2016). It is possible to note that developed countries discuss the prevention of diseases, and chronic research illnesses, use technologies and consider moral issues arising in the healthcare industry (Barreto, 2017). In contrast, developing countries focus on malnutrition, life expectancy at birth, and infections (Barreto, 2017). As mentioned previously, the concern is efficiency and quality in developed countries. The economic differences in developed and developing countries are now growing into a gap between the poor and the poorest countries on the one hand, and the rich and the richest, on the other. The situation is particularly dire in the least developed countries because they have the highest concentration of disease dissemination and dangerous environmental conditions (“Global Sustainable Development Report,” 2019). However, there is evidence that developed countries face an issue of “flat-of-the-curve medicine” when intensive health interventions have a low impact on a person’s recovery (Bloom, Kuhn, & Prettner, 2018). Thus, both advanced and emerging countries suffer from inequality distribution of the healthcare system.

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When the Affordable Care Act (ACA) was passed in 2010, the healthcare community was charged with putting a greater emphasis on population health, defined as the health outcomes of groups of individuals. Since then, the roles and responsibilities of nurses on all levels have evolved. Because nurses often serve as the primary contact for patients, families, and communities, they play a crucial function in improving how the healthcare system responds to issues, the National Advisory Council on Nurse Education and Practice (NACNEP) said.  The NACNEP, which advises the U.S. Department of Health and Human Services and Congress on nursing education and practice, said nursing education and educators must meet the new demands of the changing healthcare system to promote health equity. The organization recommends shifting the current undergraduate nursing education model from acute care to a broad-based approach focusing on population health, particularly in underserved communities.  “For these populations, nurses need to develop broad-based knowledge, have a cradle-to-grave perspective on health, and learn to work and collaborate in new models of care, including interprofessional healthcare teams,” the organization said in its “Preparing Nurses for New Roles in Population Health Management” report. Indeed, nurse leaders are positioned to redress health inequities in several ways. Since DNP-educated nurses play roles in healthcare leadership and nursing education, they can advance healthcare equity in population health and nurse education. 

The Association of Public Health Nurses (APHN) and other healthcare organizations have offered recommendations for nurse leaders as they strive to promote equity in healthcare:

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·        Be mindful of the approach: Many communities with little to no healthcare access remain leery of providers, sometimes because of language barriers and other times due to a lack of nearby services. Small steps to build trust, such as seeking immersion experiences, can ingratiate nurses into a community. In learning about community challenges, nurses should remember to display humility and respect for cultures, traditions, and beliefs. An awareness of cultural differences can promote more significant ties to the community.

·        Examine the underlying causes of illness and disease in a community: Review the social determinants of health, including the conditions in which residents live, work, and age, for a deeper understanding of what causes medical problems. By reviewing the multiple underlying factors of poor health conditions, nurses can begin to peel back the layers of health inequities. Work can establish pathways to strengthen individual and community health.

·        Work collaboratively with the community: Establishing a foundation for equity in healthcare means chipping away at divisiveness, and that strengthens the community. Communities that consider themselves entire stakeholders in health outcomes can be total contributors to the process and progress. The APHN said nurses are responsible for building new relationships, strengthening old relationships, and encouraging community members to take charge to create health equity.

·        Establish partnerships: Partnerships with community groups, organizations, elected and appointed officials, health and human service professionals, and volunteers should be focused on improving human conditions in specific communities.  By working with other agencies and institutions, nurses and other stakeholders can identify strategies, create action plans, and implement approaches for health equity.

·        Advocate for needs: DNP-educated nurses are positioned to advocate for community needs. Advocacy begins with identifying specific needs, determining who can take the appropriate actions, and encouraging dedicated support for improvements. The primary goal should be for the community.

“Public health nursing leaders are often uniquely placed in government agencies and are often in a position to be consulted on issues related to policy and legislation,” the APHN said. These opportunities should be embraced as an opportunity to help ‘put face’ on public health issues and problems.

Barreto, M. L. (2017). Health inequalities: A global perspective. Associação Brasileira de Saúde Coletiva, 22(7), 2097–2108.

Bloom, D., Kuhn, M., & Prettner, K. (2018). Health and economic growth.

Frogner, B., Frech, H., & Parente, S. (2015). Comparing the efficiency of health systems across industrialized countries: A panel analysis. BMC Health Services Research, 15(415).

Global sustainable development report 2019: The future is now – science for achieving sustainable developmentThe United Nations.

https://www.hrsa.gov/advisory-committees/nursing
https://www.apha.org/apha-communities/member-sections/public-health-nursing

Wiblin, R. (2016). developing countries.

RESPOND HERE

I agree with you that health is ever-changing due to various dynamics in healthcare environment. However, the transformation in healthcare differs between the developed and underdeveloped worlds. There are central health concerns in developed countries, such as healthcare system expenditure (Workie et al., 2020). In the underdeveloped world, healthcare concerns are different. Political instability and high poverty levels in underdeveloped world has affected reliable healthcare transition. Other countries have been forced to depend on donations and financial assistance from developed nations.  High mortality rates have been reported in developing world for HIV/AIDS, tuberculosis, malaria, and other communicable diseases (Barbier & Burgess, 2020). Unfortunately, healthcare providers and workers have struggled to contain these healthcare complications amidst poor healthcare infrastructure. It is possible to note that developed countries discuss the prevention of diseases, and chronic research illnesses, use technologies and consider moral issues arising in the healthcare industry.  Underdeveloped nations on the other hand are always concerned with malnutrition, life expectancy at birth, and infections.

References

Barbier, E. B., & Burgess, J. C. (2020). Sustainability and development after COVID-19. World development135, 105082. https://doi.org/10.1016/j.worlddev.2020.105082

Workie, E., Mackolil, J., Nyika, J., & Ramadas, S. (2020). Deciphering the impact of COVID-19 pandemic on food security, agriculture, and livelihoods: A review of the evidence from developing countries. Current Research in Environmental Sustainability2, 100014. https://doi.org/10.1016/j.crsust.2020.100014

Underdeveloped countries experience a lot of health concerns compared to the type of health concerns in developed countries. In underdeveloped countries, environmental contamination from solid waste mismanagement poses a serious health threat to the people.  This can be seen as open dumping and open burning which the main waste treatment and final disposal systems are practiced in these in low-income countries and cause serious air pollution and water contamination. Poor unsustainable disposal practice worsens solid waste management (Ferronato & Torretta, 2019). Some serious communicable diseases like Cholera, Hepatitis A, and Typhoid are linked to contaminated water while allergies, acute respiratory infections, lung cancers, and heart diseases are some of the diseases associated with burning air pollution (Ferronato & Torretta, 2019). In developed countries, the disposal of waste materials is more structured and well organized compared to the indiscriminate solid waste disposal and open incineration reported in underdeveloped countries. Various factors contribute to health disparities and the gap between the poor and vulnerable populations and the rich are evident. Assessment of socioeconomic status (SES) and mortality indicates that mortality rates are higher among individuals of lower SES who die at younger ages than their high-SES counterparts. Socio-political participation and socioeconomic status (SES) determine participation where participation is higher among individuals of higher SES  while the disadvantaged make up the lower group (Rodriguez, 2018). A poor economy is linked to high morbidity and mortality. When people live and thrive in a poor economy, economic inequality exists. Poverty is associated with increased diseases and poor health. This conversely affects the social determinant of health. Khullar and Chokshi  (2018) pointed out that poor adults are five times as likely as those with incomes above 400 percent of the federal poverty level to report being in poor or fair health. This group is also reported as having chronic non-communicable diseases and is less likely to have health insurance or access to healthcare. Health literacy and health education are vital in the promotion of any population’s health. The DNP can exert the educational acquisition in organizing health awareness initiatives to would draw attention to the health risks and consequences associated with unacceptable poor health behaviors of solid waste management seen in underdeveloped countries and advocate for improved health behaviors.

Reference

Khullar, D., & Chokshi, D. A. (2018). Health, income, & poverty: Where we are & what could help. Health Affairs, 10.

Ferronato, N., & Torretta, V. (2019). Waste mismanagement in developing countries: A review of global issues. International journal of environmental research and public health, 16(6), 1060.

Rodriguez, J. M. (2018). Health disparities, politics, and the maintenance of the status quo: A new theory of inequality. Social Science & Medicine, 200, 36-43.

RESPOND HERE

PATIENCE it is true that the underdeveloped countries experience a lot of health concerns compared to the type of health concerns in developed countries. Unfortunately, most underdeveloped nations have poor healthcare infrastructure despite high vulnerability rates due various healthcare complications (O’Cathain et al., 2019). Environmental contamination from solid waste mismanagement poses a serious health threat to the people in underdeveloped world. High poverty rates in the underdeveloped world has thwarted the efforts to increase the accessibility, quality, and availability of healthcare services. Developed world with reliable healthcare infrastructure have reduced mortality rate to various healthcare complications (Spoorthy et al., 2020). Various factors contribute to health disparities and the gap between the poor and vulnerable populations and the rich are evident. However, these health disparities interfere with quality healthcare provision in the affected countries. A poor economy is linked to high morbidity and mortality. When people live and thrive in a poor economy, economic inequality exists. Underdeveloped world is characterized by poor economy.

References

O’Cathain, A., Croot, L., Duncan, E., Rousseau, N., Sworn, K., Turner, K. M., … & Hoddinott, P. (2019). Guidance on how to develop complex interventions to improve health and healthcare. BMJ open9(8), e029954. http://dx.doi.org/10.1136/bmjopen-2019-029954

Spoorthy, M. S., Pratapa, S. K., & Mahant, S. (2020). Mental health problems faced by healthcare workers due to the COVID-19 pandemic–A review. Asian journal of psychiatry51, 102119. https://doi.org/10.1016/j.ajp.2020.102119

Underdeveloped- developing countries there are more parasitic diseases such as malaria and the HIV/AIDs which has remained a pandemic causing major health problems. There are also non-communicable diseases relating to poor diet and clean water has remained prevalent and has negatively impacted the health of the population. Mortality and morbidity have been on the increase with life expectancy decrease. In developing countries, the health care system has more at hand in controlling non-communicable disease and nutrition relates illness. This population faces double burden health concerns from both communicable and non-communicable diseases which exacerbates health inequities between developed and underdeveloped countries Whereas in industrialized countries there is marginal control on infectious disease epidemiology shows increase in epidemics of heart diseases and blood vessel issues such as hypertension, ischemic heart disease, diabetes, cerebrovascular disease, obesity, and caner. These chronic diseases are now major contributors to health burden of developed and developing countries. These diseases are attributed to economic development of referred to as diseases of the rich. Developed countries face health problems from industrialization, environmental pollution, habitat fragmentation, degradation sue to deforestation, rapid development of agriculture and urbanization leading to hazardous emissions that pollute the environment (Hoang 2019). Lack of access to health care, unstable political climates,  availability of resources  and affordability contributes to health disparities.

DNP prepare nurse could help to reduce these global health disparities by advocating to the authorizes to continuously modify their health care services, address needs created by disease. Increase epidemiolocal surveillance, give attention to health issues adequately, distribute health resources to remote, rural areas. Engage in public health education promote healthy lifestyles reinforce behavior change essential to prevent and control diseases such as smoking, excessive alcohol, dangerous drugs, encourage vaccines and increase access to health care services (Do TTH et al 2019).

Do TTH, Ly TBT (2019) Development of a procedure for evaluating the impacts of the accidental emission of hazardous chemicals, case study in Ho Chi Minh City, Vietnam. Environ Manage. https://doi.org/10.1007/s00267-017-0979-0

Hoang, T. C., Black, M. C., Knuteson, S. L., & Roberts, A. P. (2019). Environmental pollution, management, and sustainable development: Strategies for Vietnam and other developing countries. Environmental management63(4), 433-436.

REPLY

IRENE I concur with you that in underdeveloped world there is high mortality rates as a result of malaria, HIV/AIDs among other healthcare complications. Unfortunately, political instability and high poverty rates have complicated accessibility to quality and affordable healthcare services. Poor people in these regions are unable to afford quality healthcare services due to high poverty rates (Khan et al., 2019). The situation is different in the developed world. The developed world is privileged to have reliable healthcare infrastructure. Besides, low poverty rates in developed world has increased access to quality healthcare services for most people. . In developing countries, the health care system has more at hand in controlling non-communicable disease and nutrition relates illness. The health disparities between the developed and underdeveloped worlds have impacted global healthcare sector (Loayza & Pennings, 2020).  Different government and health-related institutions have invested in projects that aim at improving healthcare in underdeveloped world. The collective efforts have benefitted developing nations in managing healthcare problems such as HIV/AIDs and the current COVID-19 pandemic.

References

Khan, B. A., Cheng, L., Khan, A. A., & Ahmed, H. (2019). Healthcare waste management in Asian developing countries: A mini review. Waste management & research37(9), 863-875. https://doi.org/10.1177/0734242X19857470

Loayza, N., & Pennings, S. M. (2020). Macroeconomic policy in the time of COVID-19: A primer for developing countries. World Bank Research and Policy Briefs, (147291). Available at SSRN: https://ssrn.com/abstract=3586636

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