HCM425 DB5

Nursing homework

HCM425 IP5

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Proposal: Addressing Hypertension Among African Americans in Georgia

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Proposal: Addressing Hypertension Among African Americans in Georgia

Hypertension has become one of the prevailing issues related to public health, particularly in Georgia's African American population. Hypertension elevates blood pressure levels and is a primary cause of cardiovascular disease, stroke, and renal failure. Georgia has a high population of African Americans, and this ethnic group is more predisposed to hypertension. This increased risk is partly due to socioeconomic differences, psychosocial stress, and neighborhoods where the promotion of healthy living is not supported. Managing these social determinants of health is important in decreasing hypertension and enhancing cardiovascular health among African Americans in Georgia. As the Program Manager, I am tasked with proposing an intervention to reduce the incidence and prevalence of hypertension in this vulnerable population. This proposal outlines a needs assessment, morbidity and mortality data, incidence and prevalence rates, and a tailored intervention program with a cost analysis.

Needs Assessment

Demographics

The African American population comprises a third of Georgia's total inhabitants. Most are found in urban settings like Atlanta, with clear distinctions in income levels (Health Resources and Services Administration, 2021). African Americans in Georgia are disadvantaged in poverty level, health cover, and education compared to their white neighbors. These factors raise the possibility of hypertension in this group of people.

Social Factors Increasing Risk

Poverty is a major social factor of high blood pressure in Georgia's African Americans. Low-income people eat high-calorie, low-nutrient, high-sodium diets because they cannot afford nutritious meals. Uncontrolled hypertension is also caused by poor healthcare access and not getting regular checkups. The fact that many Americans lack health insurance and only attend the hospital in emergencies exacerbates the problem. Hypertension also depends on race and ethnicity. Black Americans have high blood pressure due to genetics, racial prejudice, and other socioeconomic causes. Chronic stress, often resulting from systemic racism, causes long-term hypertension and related health complications. Many African American neighborhoods lack safe places to exercise and vitamin-producing greengrocers. The social variables create settings that encourage hypertension to develop and remain unmanaged.

Morbidity and Mortality Data

Hypertension is among the major causes of morbidity and mortality in African Americans in the state of Georgia. The disorder increases the risks for some prevalent conditions, such as heart disease, stroke, and kidney failure, especially in this population. According to Dunklin (2020), African Americans residing in Georgia are twice as likely to die from hypertension compared to their white counterparts. This disparity is attributed to genetic predisposition, socioeconomic issues, and reduced healthcare. Mortality rates from hypertension-related diseases are especially high in urban areas such as Atlanta, where the African American population is concentrated.

Incidence and Prevalence Data

African Americans in Georgia are particularly vulnerable to hypertension as the rates of incidence and prevalence are high. According to the national data, nearly 47% of African American adults suffer from hypertension, a figure that is higher than other ethnic groups. In Georgia, 40. 5 % percentage of African American adults said that they were advised by a health professional that they had high blood pressure (America's Health Rankings, 2024). Hypertension is common in this group because of conditions like obesity, diabetes, and chronic stress. The prevalence of hypertension in African Americans in Georgia is increasing because of increasing obesity and diabetes rates in this population.

Suggested Intervention Program with Cost Analysis

Proposed Intervention: Community-Based Hypertension Management Program

I propose the implementation of a community-based hypertension management program. This program will focus on three main components: education, screening, and treatment. The program will provide culturally relevant health information about hypertension, including healthy behaviors such as balanced diet, exercise, and stress management. Black-majority community centers, churches, and schools will provide educational sessions. Traditional gender and other health workshops will be led by qualified healthcare professionals and community health workers who understand most attendees. Secondly, the program will include periodic blood pressure screenings at convenient locations like community centers, churches, and small health clinics. The screenings will be free, and high blood pressure patients will be referred. The goal is to detect high blood pressure patients and connect them to appropriate healthcare. The initiative aims to provide affordable medication and therapy packages for hypertension patients. Collaboration with local pharmacists and healthcare practitioners will also be needed to ensure participants receive treatment. The program will also offer life-changing counseling, focusing on African American food and fitness.

Cost Analysis

The estimated cost of implementing this community-based hypertension management program is $2 million over three years. The budget will cover the following expenses:

Educational Materials and Workshops: $500,000

Screening Equipment and Personnel: $700,000

Medications and Treatment Services: $600,000

Program Administration and Evaluation: $200,000

This investment can be justified based on the potential healthcare cost savings for the prevention and management of hypertension. The program promises a reduction of both the incidence and prevalence rate of hypertension among African Americans in the state of Georgia and consequentially less hospitalization, ER visits, as well as long-term complications related to uncontrolled hypertension.

Justification and Explanation

Hypertension management is best for Georgia's African Americans for various reasons. Illiteracy, poor health care, and socioeconomic issues are contributors to hypertension. It empowers people to manage their health by educating them and providing affordable screening and treatment that fits their cultural values. Second, the program is adaptable and may be scaled up. The plan is to use community resources to implement the program and partner with other healthcare facilities to expand it across Georgia and tailor it to local communities. Considering the health and economic effects of hypertension, early detection and prevention are vital. Finally, the program improves the health of vulnerable populations and reduces health inequities, meeting adequate public health goals. The program targets vulnerable Georgia African Americans who have the most hypertension. The program addresses social determinants of health, which could greatly affect Georgia African Americans' health.

References

Health Resources and Services Administration. (2021). Georgia – 2021 – III.B. Overview of the State. Hrsa.gov. https://mchb.tvisdata.hrsa.gov/Narratives/Overview/ed19bd42-ea83-4b67-9f4c-ae20fddd08d5

America's Health Rankings. (2024). Explore High Blood Pressure in Georgia | AHR. America’s Health Rankings. https://www.americashealthrankings.org/explore/measures/Hypertension/GA?population=hypertension_Black

Dunklin, M. (2020). High blood pressure is increasingly deadly for Black people. Www.heart.org. https://www.heart.org/en/news/2020/07/13/high-blood-pressure-increasingly-deadly-for-black-people#:~:text=Black%20people%20had%20a%20nearly

HCM425 DBR2.3 *NEED IN 6HRS*

1. Initial Question: Using CDC Wonder , choose a health condition or determinant, a specific place (county or state), and a time period (years). Review the data covering a 5–10-year period. Answer the following questions:

1. What are the morbidity and mortality rates for the health condition or disease?

2. Choose 1 year, and review the data by age, ethnicity, and gender. Do you observe any disparities within these groups?

3. What pattern or trend have you observed over the 5–10-year period?

4. What are the risk factors for the disease or health condition?

5. Does this information surprise you? If so, why?

6. How can these data be used to inform policy and prevention and intervention programs?

Respond to at least 2 of your fellow classmates with at least a 100–200-word reply about their Primary Task Response regarding items you found to be compelling and enlightening. To help you with your discussion, please consider the following questions:

· What did you learn from your classmate's posting?

· What additional questions do you have after reading the posting?

· What clarification do you need regarding the posting?

Student Post to Respond to: natalie carroll

In Tennessee for years 2000-2005, there are several diverse types of cancers, for example, there is oral cancers, digestive cancers, breast cancers, genital cancers, etc. All ‘sites’ of cancers combined in my findings resulted in 75,280 deaths in the state over a five-year period. Mortality was population is 35,000,104 (CDC Wonder, 2024).

Choosing one year out of the five, I chose 2005. Searching by age, ethnicity, and sex I found slight disparities. Specifically in my first search of non-hispanic female deaths, there were 6,012 deaths across all cancer sites combined, the leading age range for most deaths in this period is 75-79 years of age with 897 deaths in the year and the least number of deaths is 30-34 years of age with 28 deaths that year. For comparison, in 2005, I chose non-hispanic males with 6,849 deaths in 2005, which is slightly more than the female group. For the males, the most deaths were in the age range of 75-79 years of age with 1,066 deaths. The lowest number of deaths was in the age group of 25-29 years of age with 17 deaths. With comparing non-hispanic males with the females, the disparities found would be for females age range 25-29 was listed as ‘suppressed’ while the males had 17 recorded deaths in the age group. The males were slightly higher in mortality rates overall (CDC Wonder, 2024).

A pattern or trend observed in 2000-2005 would be that the higher the age, the more deaths that occurred.

Risk factors for cancers are everywhere, but there are various categories in how they play a role promoting the risk of cancer. One factor is lifestyle: tobacco, alcohol, diet, and obesity all increase the risk of cancer. Another factor is environmental factors, such as carcinogen exposure (which can be unavoidable for certain careers – like mining, chemical engineering, and construction/factory work). A third factor would be genetics, which can certainly be unavoidable in instances. Genetics play a role, such as if your family history has certain cancers or there are inherited genetic syndromes, which link genetics to an increased risk of cancers. Lastly, there are medical factors in which someone with AIDs for example, who has a weakened immune system is more susceptible to cancers, along with age playing a significant role in risk of cancers being the older in age, the risk increases, and certain infections such as Human Papillomavirus (HPV) having a direct link to a specific cancer, which is cervical (NCI, 2023).

Does this information surprise me? Not in the slightest, there are plentiful online resources to independently study health concerns, which happens to be my interest. I know most things have a link to cancer, and some are unavoidable. However, it is most important to strive to live healthy and make proper lifestyle choices to decrease any associated risks. For example, I carefully watch my diet and exercise daily in hopes to decrease my risks. My family history of strokes and skin cancers can play a role in my life later, but for now, I am healthy and striving to stay healthy.

In terms of how data can be used to inform policy and prevention and intervention programs, data from cancer registries can show higher incidences of lung cancer in regions with high smoking rates. This evidence can justify stricter tobacco control policies and support smoking cessation programs. For intervention programs, Clinical data can refine treatment guidelines to improve patient outcomes and reduce side effects. Data helps policymakers allocate resources efficiently, ensuring high-risk areas and populations receive adequate funding for prevention and treatment. Information on the prevalence of virus-related cancers (e.g., HPV and cervical cancer) can justify the implementation of vaccination programs (CDC, 2023).

2. Student Post to Respond to: Dwethe Brown

Diabetes is a chronic condition that affects about 97 million adults. In the United States, 16 percent of adults ages 20 and above were diagnosed with diabetes. Some adults have diabetes but are not aware that they have the disease. In 2021 diabetes was the eighth leading cause of death. In 2019 The World Health Organization estimated that diabetes was the direct cause of 1.5 million deaths globally, with 48 percent of these deaths occurring before age 70. (Organization, 2023) Older people tend to have a higher death rate due to diabetes.

African Americans are 60 percent more likely to be diagnosed with diabetes. In 2018 12 percent of black women were diagnosed with diabetes. This group of individuals were more likely to have complications from the disease. For instance, a high rate of African Americans suffered from kidney disease caused by diabetes. Genetics and environment contributed to the number of African Americans getting diabetes. Black women get diagnosed with diabetes due to obesity. Socioeconomic status contributes to this high rate of obesity. Lack of access to nutritious food, and lack of healthcare are factors for the prevalence of diabetes in black women.

Diabetes increased tremendously over the years for individuals eighteen years and older. In 202138 million individuals of all ages were diagnosed with diabetes. For example, 13 percent of adults with less than high school had a higher rate of getting the disease than those with a high school education. Families living above the federal poverty line had low rates of diabetes disease.

Having diabetes can lead to issues with the nervous, immune, and circulatory systems. Diabetes can cause fatigue; blurred vision increases hunger and weight loss. Having diabetes decreases life expectancy. Individuals diagnosed with diabetes have an increased chance of suffering from a heart attack or stroke. Diabetes can damage the kidneys, eyes, and heart.

This information does not surprise me due to the lifestyle habits of today’s society. Today overeating, smoking, and lack of exercise seem to be how most individuals live. Lack of resources also plays a major role in an individual getting diagnosed with diabetes. There is a large population that are not insured and can not get proper treatment for the condition. In my community, most families suffer from diabetes.

This data can be used to improve and prevent the disease. The data can be used to create policies that support low-income areas with insurance or access to healthy living classes. Programs can create a lower prevalence of the disease and focus on prevention. Based on population statistics, programs can be developed to support controlling the disease. Using population data allows for the prevention of the disease, by helping individuals change lifestyle habits and assisting individuals to manage diabetes better.

3. Initial Question:

As you peruse the Web sites above, respond to the following questions:

· How do the 3 behaviors in the 3-4-50 model impact the 4 diseases in your community?

· Can you find the mortality of these 4 diseases in your community?

· If you can, what is the percentage of deaths caused by these 4 diseases for your community?

· What are the underlying social determinants of health that impact the 3 behaviors in the 3-4-50 model?

· What are the health disparities observed from the data in your community (city or county)?

· Physical activity, or lack thereof, is 1 of the 3 behaviors that impacts the 4 diseases. What is the walkability index for your neighborhood (area)?

· Does this support the data as they relate to health conditions that are impacted by physical activity?

· From the data and the information you gathered, what recommendations might you have for your community?

·

Respond to at least 2 of your fellow classmates with at least a 100–200-word reply about their Primary Task Response regarding items you found to be compelling and enlightening. To help you with your discussion, please consider the following questions:

· What did you learn from your classmate's posting?

· What additional questions do you have after reading the posting?

· What clarification do you need regarding the posting?

Student Post to Respond to: Lucila Morales

The concept behind the 3-4-50 model is defined as to be risky and unhealthy behavior related to diet, sedentary lifestyle, and tobacco use, which can lead to chronic and worse health conditions leading to 50% of all deaths.

For this week topic I want to provide a very important information related to the San Bernardino County, this is my community the 3-4-50 model three behavior are tobacco, poor diet and physical inactivity. These three behaviors influence four major diseases: heart disease, high blood pressure, stroke, and diabetes ( San Bernardino, California | County Health Rankings & Roadmaps, 2024). Tobacco usage can contribute to heart diseases. Poor diet contributes to high cholesterol/ high blood pressure.

The percentage of San Bernardino County residents diagnosed with heart disease decreased from 7.6% in 2017 to 5.1% in 2018, although the 2017 data is considered unstable and should be approached cautiously. In 2017, the heart disease mortality rate in the county was 184.7 deaths per 100,000 residents, reflecting an 18% reduction since 2008 and a slight 1% decrease from the previous year. In 2018, 10.8% of adults were diagnosed with diabetes, down from 14.6% in 2017, with a long-term trend showing relative stability around 10.6% since 2009. However, the diabetes death rate increased slightly from 34.5 per 100,000 in 2017 to 35.1 per 100,000 in 2018, marking a 19% rise since 2009. High blood pressure affected 29.5% of adults in 2018, unchanged from 29.7% in 2017. Stroke-related deaths, linked to high blood pressure, increased by 1% from 42.0 per 100,000 in 2017 to 42.4 in 2018, with a variable but slightly declining trend since 2009 ( Chronic Disease, 2024).

San Bernardino County faces various social determinants of health that worsens the impact of these behaviors.

Economic Stability: High poverty rates and limited access to healthcare contribute to poorer health outcomes. Financial constraints often lead to unhealthy dietary choices and reduce access to preventive healthcare. Low employment opportunities 4.1 % of these community are 16 and up seeking a job ( San Bernardino Countywide Vision, 2024.

Education: Lower levels of education correlate with higher rates of smoking and poor diet. Health literacy is a significant barrier, particularly in communities with less educational attainment. High School Completion 81% of San Bernardino young adults around age 25 yeas and up had completed a high school degree or their GED ( San Bernardino Countywide Vision, 2024.

Neighborhood and Built Environment: The county has areas with low walkability and limited access to parks and recreational facilities, discouraging physical activity ( San Bernardino Countywide Vision, 2024.

In San Bernardino County, several health disparities are evident based on the data distributed by Chronic Disease (2024):

Heart Disease: Despite a general decline in heart disease prevalence, there remain disparities in mortality rates, particularly among different racial and socioeconomic groups. Communities with lower income and access to healthcare experience higher rates of heart disease and related complications.

Diabetes: Diabetes prevalence has shown fluctuations, with higher rates observed in areas with limited access to healthy foods and healthcare. Minority populations, particularly Hispanic and African American communities, have higher rates of diabetes, reflecting disparities in diet, healthcare access, and health education.

Stroke: Although stroke mortality has seen a slight decline, it remains disproportionately high in populations with uncontrolled hypertension, often linked to lower socioeconomic status and limited access to preventive care

The walk Score in the city I live in Bloomington 50/100 is the recent known data received. Yes, it supports the data recorded on the San Bernardino data base related of chronic diseases, Due to walkability level been low, most of the resident lack of lifestyle results in poor diet, exercise and a higher rate of tobacco overuse just to mention some ( cdph.ca).

To address these issues, the following actions are recommended:

7. Enhance Access to Healthy Foods: Expanding access to fresh, affordable produce through community gardens, farmers' markets, and improved grocery store availability in food deserts.

8. Promote Physical Activity: Invest in infrastructure to increase walkability and create safe, accessible spaces for exercise, such as parks and trails.

9. Strengthen Health Education: Implement community-based health education programs that focus on smoking cessation, nutrition, and the importance of physical activity.

10. Improve Healthcare Access: Increase the availability of affordable healthcare services, including preventive care, screenings, and chronic disease management programs.

These strategies could significantly reduce the burden of chronic diseases and improve overall public health in San Bernardino County ( cdph.ca) .

4. Student Post to Respond to: Krystal Coughlin

In Lafayette, LA, three significant health behaviors—adult smoking (19%), adult obesity (39%), and excessive drinking (21%)—are closely linked to various health conditions and social determinants. These behaviors contribute to the prevalence of cancer (6.2%), heart disease (5.6%), respiratory illness mortality (41.1%), and preventable hospitalizations related to Medicare (2803 per 100,000 enrollees).

Adult Smoking (19%): Smoking is a well-known risk factor for several types of cancer, including lung, throat, and mouth cancers. It also significantly increases the risk of heart disease by damaging blood vessels and contributing to plaque buildup. Additionally, smoking worsens respiratory illnesses, leading to higher mortality rates from conditions like chronic obstructive pulmonary disease (COPD) and emphysema. The high smoking rate in Lafayette contributes to the elevated rates of these health conditions.

Adult Obesity (39%): Obesity is a major risk factor for heart disease, as it often leads to hypertension, high cholesterol, and diabetes, all of which strain the cardiovascular system. Obesity is also linked to certain cancers, such as breast, colon, and kidney cancers. Additionally , obesity can worsen respiratory conditions by reducing lung function and increasing the risk of sleep apnea. The high obesity rate in Lafayette is a significant contributor to the area's health challenges.

Excessive Drinking (21%): Excessive alcohol consumption is associated with various cancers, including liver, breast, and esophageal cancers. It also contributes to heart disease by raising blood pressure and causing heart muscle damage. Alcohol abuse can lead to respiratory issues through aspiration pneumonia and other complications. The high rate of excessive drinking in Lafayette worsens these health problems.

Social Determinants: Income inequality, unemployment, injury deaths, and children in poverty are critical social determinants that impact health outcomes. Lafayette has a notable income inequality ratio, with significant disparities between the highest and lowest earners. Unemployment, currently at 4.2%, limits access to healthcare and healthy lifestyle choices. Injury deaths, at 82 per 100,000, reflect the community's safety challenges. Additionally, 20% of children in Lafayette live in poverty, which affects their access to nutritious food, safe environments, and healthcare.

Walking Score: Lafayette's walking score of 42 indicates that it is a car-dependent city, This low walkability score can contribute to higher obesity rates and related health issues, as residents have fewer opportunities for physical activity in their daily routines.

For Lafayette, LA I would recommend that that there should be an increase in bike paths and side walks allowing people to become more active. Most people have to drive their car to run errands. The most popular place to smoke is in the car while driving.

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