NRS 429 Topic 4 Health Promotion in Minority Populations GCU

The American healthcare system is faced with the great challenge of inequality which displays a disproportionate impact on marginalized communities, including people of color (Boyd et al., 2020). Such inequalities are the reason behind the gaps in the acquisition of health insurance coverage, leading to uneven access to care services and poor health outcomes among the minority populations. Additionally, studies show that African Americans are significantly impacted by these inequalities contributing to the high prevalence of chronic conditions such as hypertension and diabetes, in addition to the increased mortality rates among this minority population. This discussion provides an analysis of the health status of African Americans, as part of the minority population, in comparison to the national average.

Health Status of African Americans

African Americans make up approximately 13.4% of the United States population. The current health status of black Americans displays an increased prevalence of chronic conditions such as hypertension, obesity, cardiovascular diseases, sexually transmitted infections, and diabetes as compared to whites. Increased morbidity and mortality rates among African Americans have been associated with several economic and social factors. For instance, studies show that African Americans have a more likelihood of not seeing a doctor when they are sick, as a result of high healthcare costs (Yearby, 2018).

Despite the significant advances in the current healthcare system in the U.S., there is still evidence reporting that racial and ethnic minorities such as black Americans still receive a lower quality of care services leading to poor health outcomes as compared to the whites. As of 2019 August, it was reported that approximately 68 million people had been covered by the Medicaid program, with black Americans accounting for 20%. Given that most black Americans have lower social and economic status, they tend to be poorer than other demographic groups, hence making it harder for them to enroll in health insurance programs like Medicaid.

Health Disparities

The death rate among African Americans has declined by about 25% over the past 17 years precisely for populations above the age of 65 years, as reported by the Centre for Disease Control and Prevention (CDC). However, studies also show that young African Americans have a higher probability of dying at an early age as a result of increased risks for stroke, heart disease, cancer, pneumonia, diabetes, and HIV/AIDs among other conditions, as compared to their white counterparts. Social factors common among this minority group contributing to the above-mentioned health disparities include unemployment, smoking, alcoholism, obesity, sedentary lifestyle, and poverty among others (Bell et al., 2020).

Consequently, this group of individuals is also faced with nutritional challenges such as unfavorable nutritional environments, food deserts, food swamps, and food insecurities. For instance, black Americans are associated with poverty and a low level of education, which makes it hard for them to access quality and healthy foods as compared to the economically rich racial majorities. They end up consuming fast foods, among other unhealthy foods, which increases their risk of cardiovascular conditions and obesity.

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Barriers to Health

            Various barriers to the accessibility of quality health care services have been identified for the

African American population. Predominating barriers include decreased understanding of care plans, inability to pay for care services, lack of transportation to care facility, and the inability of incorporating the recommended health care plans into their routine daily living pattern. These barriers are associated with several cultural, educational, socio-political, and socioeconomic factors.

For instance, cultural beliefs among African Americans promoting unhealthy eating habits and sedentary lifestyle, in addition to failure to follow up on routine screening, negatively affects their overall health and utilization of healthcare services irrespective of their social or financial status (Lewis & Dyke, 2018). Consequently, the low socio-economic status among African Americans in terms of low income, unemployment, low education level, and occupation status is also a significant inhibitory factor towards accessibility to quality healthcare services. Lastly, as part of the minorities, blacks in the U.S have limited political influence towards the development of appropriate policies such as the “Obama Care,” to promote their access to quality care services.

Health Promotion Activities

With regard to the numerous health disparities affecting African Americans, several health promotion activities have been proposed over the years to help promote the health and well-being of this minority group. The self-help initiative was introduced among African Americans to promote taking personal responsibility for their health and improving their quality of life. Self-help health promotion practices among black Americans include routine screening for predominating health conditions, physical exercise, healthy diet plans, adoption of recommended care plans, and disease prevention practices at home (Fletcher et al., 2018). Consequently, for the religious members of the community, faith-based organizations like churches have promoted structural health promotion activities including education, health fairs, and smoking cessation among others.

Approach for Health Promotion and Disease Prevention

            One of the most effective approaches that can be utilized by African Americans in promoting their health as part of the care plan is the adoption of Pender’s health promotion model. According to the CDC, black Americans are at high risk of chronic diseases, with cardiovascular diseases being the leading cause of death among this group of individuals. Health promotion practices focusing on lifestyle modification have displayed great significance in reducing the risks of cardiovascular diseases.

Pender’s health promotion model, on the other hand, provides a foundation promoting the examination of the background influences of this minority population, in line with the health promotion practices that can lead to a healthy lifestyle (Fletcher et al., 2018). At the primary level, this model encourages regular exercise and a healthy diet to prevent chronic diseases and promote healthy living. At the secondary level, the model promotes routing screening for hypertension, diabetes, and cancer among other common diseases. Lastly, at the tertiary level, the model promotes education programs and rehabilitation among the affected individuals.

Cultural Beliefs and Practices

Other than social and economic factors, several cultural factors among black Americans must be considered when developing the most effective care plan. Some of such cultural beliefs include lack of trust in complementary medicine, misconceptions about immunization, and strong religious beliefs against organ donation among other medical procedures. With the theory of cultural humility, clinicians can now come up with flexible care plans, while still upholding the patients’ cultural values and beliefs (Boyd et al., 2020). This theory is based on the importance of preventing cultural discrimination and promoting the equal provision of care to the culturally diverse population.

NRS 429 Topic 4 Health Promotion in Minority Populations GCU Conclusion

Health promotion practices are crucial among the general population in disease prevention and improved quality of life. Minority populations such as African Americans, are faced with numerous health disparities as compared to the whites, hence the need for more health promotion activities. However, when coming up with a care plan for this minority population, it is necessary to identify and respect their cultural values and beliefs to promote positive outcomes.

NRS 429 Topic 4 Health Promotion in Minority Populations GCU References

Bell, C. N., Sacks, T. K., Tobin, C. S. T., & Thorpe Jr, R. J. (2020). Racial non-equivalence of socioeconomic status and self-rated health among African Americans and Whites. SSM-population health, 10, 100561.https://doi.org/10.1016/j.ssmph.2020.100561

Boyd, R. W., Lindo, E. G., Weeks, L. D., & McLemore, M. R. (2020). On racism: a new standard for publishing on racial health inequities. Health Affairs Blog, 10(10.1377). https://doi.org/10.1377/hblog20200630.939347

Fletcher, G. F., Landolfo, C., Niebauer, J., Ozemek, C., Arena, R., & Lavie, C. J. (2018). Promoting physical activity and exercise: JACC health promotion series. Journal of the American College of Cardiology, 72(14), 1622-1639. https://doi.org/10.1016/j.jacc.2018.08.2141

Lewis, T. T., & Van Dyke, M. E. (2018). Discrimination and the health of African Americans: The potential importance of intersectionalities. Current Directions in Psychological Science, 27(3), 176-182. https://doi.org/10.1177/0963721418770442

Yearby, R. (2018). Racial disparities in health status and access to healthcare: the continuation of inequality in the United States due to structural racism. American Journal of Economics and Sociology, 77(3-4), 1113-1152. https://doi.org/10.1111/ajes.12230

 

 

NRS 429V Week 1 Discussion 2

In the assigned reading, “How to Write Learning Objectives That Meet Demanding Behavioral Criteria,” Kizlik explained that “objectives that are used in education, whether they are called learning objectives, behavioral objectives, instructional objectives, or performance objectives are terms that refer to descriptions of observable behavior or performance that are used to make judgments about learning.” How do health providers design educational programs to clearly articulate objectives to engage both patients as well as families?

According to the family systems theory, a member of a family has to change its behaviors and influence everyone in the family to follow along and change to promote health and wellness. An example is a family member with a history of obesity decides to lose weight and creates a diet plan and exercise regimen and encourages the rest of the family to join him in the journey of losing weight. Behavioral changes when an individual decides to change for the better and act on it.

The family systems theory helps in teaching behavioral changes because once a family member is involved in the plan of care and already decides to take part in the process of helping to live a better lifestyle, it is much easier to influence the rest of the family.

According to the ebookHealth Promotion: Health & Wellness Across the Continuum, variables that affect the ability to learn are race, ethnicity, immigration status, disabilities, sex/gender/sexual orientation, environmental threats, poverty, access to health care, and lack of education can be barriers that affect a patient’s ability to learn and move forward with the behavioral changes.

A patient’s readiness to learn to change their lifestyle for a better life improves the learning outcomes because once a patient understands the reasoning behind the need for the change, it is easier to change its bad habits to new habits and live a healthy lifestyle.

NRS 429 Topic 4 Health Promotion in Minority Populations GCU References

Grand Canyon University (Ed). (2018). Health promotion: Health & wellness across the continuum. Retrieved from https://lc.gcumedia.com/nrs429vn/health-promotion-health-and-wellness-across-the-continuum/v1.1/

Response

This is an outstanding response Ronald. I agree with it. Health conditions tend to emanate from intricate factors such as those advanced by social, economic, and political determinants. Health is determined by the manner in which societies are structured and how health policy agendas are influenced by the political nature in the society (Laverack, 2017). Health promotion interventions that address behavioral risks are capable of supporting policies to enhance health or uphold inequalities in a society.

This is attributed to the fact that behavioral change models have insignificant impact on wider conditions that result in poor health. Therefore, any health promotion model intended to initiate behavioral changes should be adopted as a component of a winder, inclusive policy framework. Ensuring a comprehensive and multi-component health promotion model is appropriate in changing bad behaviors that can cause negative health effects (Laverack, 2017). Advancing health promotion model through a strong policy framework is crucial in giving people greater control over their lives instead of instructing them on what to do.

NRS 429 Topic 4 Health Promotion in Minority Populations GCU References

Laverack, G. (2017). The challenge of behaviour change and health promotion. Challenges, 8(2), 25.

Developing health promotion programs that helps to set up healthy lifestyle behavior requires comprehensive planning. Theories and Models both include concepts and constructs. Health theories and behavior models helps to explain why individuals and communities behave the way they do.

Theories and models both include concepts and constructs. Concepts are the primary components of a model or theory. Constructs are components that have been created for use in specific model or theory. These terms are important to understand when discussing models and theories (Glanz, Rimer, &Lewis,2002).

Theories and models helps to understand the nature and understanding of the patients. In Tran theoretical model describes the process of how the behavior of individual changes, there are various factors that influence the behavior of patient.

These model includes five stages (Glanz, Rimer, &Lewis,2002;NCI, 2005)

Pre contemplation– In this stage the individual has no intention to change behavior within the next six months.

Contemplation- In this stage, an individual is considering a behavior change within the next six months.

Preparation– In this stage the individual takes some steps towards making a change doing so within the next 30 days.

Action– An individual reaches this stage once he/she has made a apparent behavior change and doing within next 30 days.

Maintenance– If behavior change last more than 6 months then moves in the final stage of maintenance.

Barriers that affect the patient’s ability to learn can be language, culture, beliefs, educational level of the patients, before set up the the plan for educating the patients nurse should assess the patient’s ability to learn and obstacles in the patient learning that can be face by the nurse.

Readiness to learn refers how patients in participating in the behavior change, patient should be ready physically, psychologically and cognitively engage in learning. Health status of the patient really affect the readiness to learn, in this patient is in pain or feeling weakness or fatigue may affect the readiness to learn. Nurse should always assess the learning style of the patient, patient’s environment such as loud noises, educational level, Nurse should always use the words as a Layman can understand, should avoid medical terms as much as possible.

NRS 429 Topic 4 Health Promotion in Minority Populations GCU Reference

Glanz, K., B. Rimer, ,& F. Lewis. (2002). Health behavior and health education. San Francisco, CA: John Wiley & Sons, Inc. National Cancer Institute (2005). Theory at a glance guide for health promotion practice.

Falkner (2018) defines cultural competence as “being aware of differences related to culture and adjusting plans of care accordingly as well as remaining sensitive and respectful of choices patients may make based on their culture.” Cultural competence is a continuous process because nurses work with others with different cultural views daily, and cultural practices can change over time. Competence in one’s culture and values provides a holistic approach to psychosocial and psychological health care needs. Nurses must utilize traditional and nontraditional care systems to offer adequate care.

Traditional care systems are healthcare methods and treatments based on western medicine that involves medical attention from a licensed medical professional. Nontraditional care systems base their treatments on herbs and home remedies without seeking attention from a licensed medical professional. Nurses should be aware of a new-coming care system called complementary alternative medicine (CAM). CAM combines traditional care systems with alternative therapies such as acupuncture, massage, meditation, yoga, and aromatherapy. Healthcare professionals incorporate a patient’s culture with these systems and understand cultural norms for that culture to offer optimal patient care.

Cultural competency is demonstrated in nursing practice by obtaining information regarding one’s beliefs and culture. Nurses and healthcare professionals can use a culture assessment tool or questionnaire to get information. A cultural assessment involves asking questions about the family dynamics, communication methods, and each person’s role in the family. Some cultures consider it disrespectful to discuss essential information without the presence of a specific family member who makes the decisions for a loved one. (Ogbuagu, 2022). This assessment aids in finding ways to communicate in place of a language barrier. Once the evaluation is complete, the nurse can implement accommodations and interventions to help further the individual indulges in their cultural beliefs about their health. These tasks demonstrate a nurse’s ability to implement cultural competency into one’s care.

NRS 429 Topic 4 Health Promotion in Minority Populations GCU References

Falkner, A. (2018). Cultural Awareness. Health Promotion: Health & Wellness Across the Continuum. (Chapter 3). Grand Canyon University. https://lc.gcumedia.com/nrs429vn/health-promotion-health-and-wellness-across-the-continuum/v1.1/#/chapter/3

Ogbuagu, P. (2022 May 20). Cultural Competence in Nursing. Nursing CE Central. https://nursingcecentral.com/cultural-competence-in-nursing/#:~:text=The%20method%20that%20a%20nurse,culture%20assessment%20tool%20or%20questionnaire.

The U.S. is a land of diverse cultural backgrounds and heritage with many different types of people based on their racial composition, beliefs, social statuses and views. The minority races are projected to become the majority in the next twenty years based on figures from federal agencies. As such, the increased diversity implies that healthcare providers and organizations must develop strategies focused on health promotion to reduce the overall healthcare cost in the country (Velasco-Mondragon et al., 2017). The diverse minorities have different cultural perspectives that affect accessibility, affordability, and quality of care provided. Therefore, health promotion can help minority populations lower cost of care and increase accessibility. As such, the paper compares and contrasts the health status of the Hispanic American population to the national average by looking at different components that define health and related services.

Description of the Ethnic Minority & Current Health Status

The Hispanic population comprises of individuals that have ancestry or origin in Cuba, Mexico, South and Central America, Puerto Rico and other Spanish cultures and background. The Census Bureau estimates that there are close to 60 million Hispanic or Latino people in the country. Imperatively, Hispanic is the largest racial minority group in the country as it constitutes about 19% of the general population. Again, it is projected that by 2060, Hispanics living in the U.S. will account for about 28.6% of the total population (Census Bureau, 2019). The Latino population is concentrated in ten states with most of them having over one million people of this minority group. These ten states include California, Arizona, New Mexico, Colorado, Georgia, Florida, Illinois, Texas, New Jersey and New York. Hispanics have a rich cultural background in food and value family life and are fluent Spanish speakers (HHS, 2020). Their cultural practices are heavily influenced by the Spanish culture.

Health Status

The health status of this population can be evaluated through different aspects that include uptake of medical or health insurance, access to health services and prevalence of lifestyle conditions among other socioeconomic determinants of health. Hispanics have limited insurance coverage compared to the general population. Hispanics constitute the highest number of uninsured individuals in the country. Figures from the Census Bureau show that in 2017, only 49% of Latino Americans had private insurance compared to the white Americans where close to 75% had medical covers. The Bureau also shows that more Hispanics depend on public health coverage than their non-Hispanic white counterparts (Census Bureau, 2019). About 17.8% of Hispanics did not have health insurance compared to about 6% of the non-Hispanic whites. These figures show that a majority of Hispanics struggle to access health services, especially preventive care.

Studies show that Hispanics are likely to suffer from, and die of, lifestyle conditions like diabetes and heart diseases as well as cancer compared to the general population (Velasco-Mondragon, 2017; Suarez-Balcazar et al., 2018).  The health of Latino Americans is impacted by different factors that include limited or lack of access to preventive care services, language barrier, and cultural issues. As indicated, a majority of this population do not have health insurance coverage. The Centers for Diseases Control and Prevention (CDC) asserts that Hispanics are susceptible to diabetes due to cultural factors (CDC, 2020). They are also susceptible to stroke, asthma, obesity, liver disease, and suicide as well as HIV/AIDS. These factors lead to increased health disparities between the Hispanic population and the general population.

Health Disparities and Nutritional Challenges of the Hispanic Ethnic Group

Health disparities are the variations and variables that contribute to inequalities or unequal distribution of healthcare resources among various demographics and population. Disparities also include preventable differences in disease burden, injury and violence or chances to attain optimal health which disadvantaged groups encounter. Specifically, disparities are associated with socioeconomic and environmental conditions of certain populations, especially among groups in racial and ethnic minorities. The Hispanic population faces income disparities leading to high rates of uninsured individuals compared to the general population (Suarez-Balcazar et al., 2018).

Hispanics have increased health risk because of limited access to health care services and are 35% more likely to have heart diseases, 50% more likely to have diabetes, and 49% likely to suffer from cancer than the non-Hispanic white counterparts. The Hispanics are 23% more likely to have obesity and 23% less likely to go for colorectal cancer screening (Velasco-Mondragon et al., 2016). These statistics imply that the Hispanic population faces nutritional challenges. The nutritional challenge that exposes the population to a host of lifestyle conditions include having a diet with less recommended amounts of vegetable, whole grains and fruits and high amounts of sodium, sugar and saturated fats way beyond the recommended amounts.

Barriers to Health for Hispanic Population

Hispanic population faces significant barriers to health stemming from culture, socioeconomics, education and sociopolitical aspects. Hispanics are more unlikely to afford the cost of care and access healthcare services due to cultural issues like language barrier. Nurses can only offer effective care if a patient understand the language used by these healthcare providers. For instance, a good number of Hispanics do not understand English and many do not complete their high school education. Hispanic cultural beliefs are diverse as each group among this racial diversity has different cultural cues that nurses and other healthcare providers must understand.

Socioeconomic barriers among the Hispanics entail poor living conditions, low income and high poverty levels than the national average. For instance, one in every four Hispanics does not have a high school certificate (Velasco-Mondragon et al, 2016). The unhealthy lifestyles of the Hispanics increase the risk for developing chronic conditions. Low educational attainment means that an individual cannot be employed in a better workplace environment. Besides not being insured, they face barriers that impact their ability to access better health care se