Paradoxical Case of Poverty and Obesity – Population Disparities Essay

Paradoxical Case of Poverty and Obesity – Population Disparities Essay
The Population Disparities Regarding Obesity in Duval County, Florida and A Social Media Campaign to Mitigate it: The Paradoxical Case of Poverty and Obesity.
(B) Community Health Nursing Diagnosis Statement
The nursing diagnosis for this paper is the increased risk of obesity among adults in Duval County. This is related to, amongst other reasons, low physical activity and an insufficient intake of fruits and vegetables. The evidence for this is demonstrated by the above average Body Mass Index (BMI) rates in Duval County and Florida in general. The BMI being a ratio, a BMI of up to 25 is considered to be normal. A figure of between 25 and 30 is however regarded as overweight. While a ratio of above 30 is obesity. Figures from recent surveys show that obesity is on the rise in the United States of America. Many American citizens are afflicted by this public health scourge that appears to be a result of lifestyle habits coupled with socio-economic status. Paradoxical Case of Poverty and Obesity – Population Disparities Essay
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(B1) Health Inequity/Disparity
According to Braveman (2014), health disparity can be defined as a difference in the health data between two sets of population demographics that can only be explained by socio-economic differences or other similar social barometers. In the United States, it has been observed that obesity and overweight is becoming a serious public health issue that is becoming more and more prevalent. However, this prevalence has been observed to follow a particular socio-economic pattern. Paradoxical Case of Poverty and Obesity – Population Disparities Essay. Those that are poor and unable to afford healthy and nutritious meals have been shown to suffer more from the phenomenon of overweight and obesity. The reasons for this have not yet been fully elucidated. Some of the reasons that have been forwarded as possible causes are the inability of persons from poor communities to access fresh produce such as fruits and vegetables. Another reason put forward has been that in the neighborhoods that poor Hispanic and Black Americans live; there is not enough security such that no one can safely jog outside their home without being mugged or robbed. Duval County in Florida is not exempt to this statistical reality. Obesity in Duval County is among the health issues making Black and Hispanic communities be unable to visit a doctor because of cost (Verité Healthcare Consulting, LLC, 2015). Paradoxical Case of Poverty and Obesity – Population Disparities Essay.
To appreciate this health disparity in the American population, it may be necessary to divide the population into subpopulations. Let us consider the population of adolescents, for instance. Babey et al. (2010) have stated that the increase in obesity noted in the United States is greater among Hispanics and African Americans. In the study that they conducted, they tested the hypothesis that the prevalence of overweight and obesity has gone up among the population of low socio-economic class adolescents as opposed to more affluent American adolescents. The other thing that they studied was whether income disparity in obesity also varies by gender (Babey et al., 2010). They examined data from a sample of 17,535 adolescents who participated in the California Health Intervention Survey conducted between 2001 and 2007. They found that obesity prevalence rates significantly went up among adolescents from poor American families. As for those adolescents from more well-to-do American families, the researchers did not find any statistically significant rise in obesity prevalence. Paradoxical Case of Poverty and Obesity – Population Disparities Essay. They therefore concluded that obesity and overweight more than doubled among poor American adolescents during the period of the survey.
Frederick et al. (2014) also studied changes and prevalence patterns of obesity among US adolescents aged between 12 and 17 years, by socio-economic status. They utilised data from the 1988 to 2010 National Health and Nutrition Examination Surveys and the 2003 to 2011 National Survey of Children’s Health. Their results revealed a most important disparity, just like in the findings of Babey et al. (2010). They found that the prevalence of obesity among adolescents from low socio-economic Americans was rising, while at the same time dropping among the population of adolescents from richer families (Frederick et al., 2014).  These same findings were found to be true by Zhang & Wang (2004) and Wang et al. (2011) Paradoxical Case of Poverty and Obesity – Population Disparities Essay.
(B1a) Primary community and Prevention Resources
In the community of Duval County, my experience showed that despite the several challenges that are prevalent in the community, some preventive measures can still be taken against obesity and overweight. Chief amongst these is a deliberate change in the lifestyle of the person affected. They can decide to stop eating junk food and take the most available healthy alternatives. One of the challenges that have been identified in this approach is that many of the victims are actually not able to afford these healthier food alternatives. What they have been advised is that they should just start making it a habit by buying the healthy food whenever they can. That way, they will make it a habit and before long, they will find themselves setting aside some money only for the buying of healthier food alternatives. Another preventive measure identified was the habit of taking regular exercises which do not necessarily have to be heavy in nature. As a matter of fact, it was found that just walking regularly (isotonic exercise) is enough to keep obesity and overweight at bay (Shaw et al., 2006). In passing this message forward, the resources available in the Duval County include family nurse practitioners and family physicians who are the resource persons that are able to influence behavior change by health education. They are also able to influence the course of obesity and overweight by making an evidence-based decision to always recommend exercise to obese and overweight persons that they see, even if they come with other disease conditions. Paradoxical Case of Poverty and Obesity – Population Disparities Essay
(B1b) Underlying Causes
As already discussed in an earlier section above, the underlying causes of obesity and overweight are the non-consumption of healthy foods and the lack of exercise in the affected population. Most of the poor Americans that are affected by overweight and obesity eat very unhealthy junk food. However, a close examination of why this is the case shows that they do this majorly because they cannot afford the healthier alternatives of foods that are available in the market. But this is only in the event that they actually have access to these healthy alternatives. The most common situation, however, is that in which the poor Americans have absolutely no access to healthy foods, even if they hypothetically had the money to buy it. This state of affairs can be explained by several observations. The first one is that the retailers that sell healthy foods have an inherent bias for wealthier neighborhoods as opposed to poorer ones. This could have been informed by either solid market research or anecdotal observations. The market research could have confirmed what has already been mentioned above. That poor Americans, because of low purchasing power, prefer mass-produced junk foods rather than clean healthy alternatives. However, if it is the anecdotal observations and experiences, then the possibility is that these businesses have given in to bigotry and discrimination based on economic status Paradoxical Case of Poverty and Obesity – Population Disparities Essay. More fundamentally, though, is the fact that insecurity in the neighborhoods in which the poor populations of Americans live is a turn-off to serious businesses. As a result, retailers who sell healthy foods will be difficult to find in neighborhoods that have rampant insecurity. All these factors therefore combine to make obesity and overweight very common among the poor populations of Americans.
(B2) Evidence-Based Practice
Research studies show, as already demonstrated above, that obesity in America shows a very clear pattern of disparity between the rich and the poor. It would be expected that obesity would affect the rich because of overfeeding. However, the paradoxical reality is that obesity is actually affecting the poor because of their poor nutritional choices. This brings to the fore the fact that it is not the quantity of the food that matters, but the quality of the same. The well-to-do Americans have learnt that nutritious food is better than junk food. They therefore frequently treat themselves to good food. But this is because they have the disposable income that can allow them to do this. The poor, on the other hand, have limited choices. To begin with, even if they wanted to buy healthier foods, they may not have the opportunity to do so as the retailers of the same have geographically discriminated against their localities based on both race and socio-economic status. However, the overriding reason is that the poor people in the poor neighborhoods cannot afford healthy foods on a regular basis.
Relevant research studies that have been referred to in relation to this problem are studies by Babey et al. (2010), Frederick et al. (2014), Wang et al. (2011), and Zhang & Wang (2004). All these studies came to the conclusion that obesity and overweight shows a significant health disparity between the rich and the poor of America. To be precise, the poor of America disproportionately suffer from obesity as opposed to the more affluent Americans. Reasons have been given as purchasing power and knowledge that healthier foods are better than junk foods. As a matter of fact, the more well-to-do Americans happen to be better educated than the poor Americans. Because of this alone, the well-off Americans appreciate the value of healthy foods and thus practice this by buying frequently the healthier foods. The poor, lacking education and knowledge, find themselves settling for the poorer choice of junk and unhealthy foods. Paradoxical Case of Poverty and Obesity – Population Disparities Essay.
(B2a) Identification of Data
Nationwide, obesity and overweight is a very big problem in America. However, as has been demonstrated above, some communities experience the problem more than others. Unfortunately, these communities happen to be those that live on the edge of or below the poverty line. They are effectively below the federal poverty levels. Studies have shown that these are mainly Black African Americans and Hispanics (Latinos). According to recent data from Duval County, Florida (2012), 28.4% of the adult population in Duval County is obese (that is they have a BMI of equal to or more than 30). At the same time, 36% of the same population are considered to be overweight (meaning they have a BMI of between 25 and 30). Going by the national figures, the figures for Duval County are actually way above the national average for both obesity and overweight (Duval County Florida, 2012). This shows that there is a significant problem of obesity and overweight in the community that needs urgent redressing. More importantly, however, the problems of obesity and overweight need to be actively addressed in Duval County for one other important reason. This is that the two are associated with significant morbidity and mortality. Obesity and overweight are associated with the development of type II diabetes mellitus, cardiovascular disease, and fertility problems (Hammer & McPhee, 2018). This means that the two conditions contribute significantly to the public health burden and must therefore be reduced at all costs. Paradoxical Case of Poverty and Obesity – Population Disparities Essay.
(C1) Social Media Campaign Objective
In order to mitigate the impact of obesity and overweight in my community in Duval County, Florida; harnessing of the current technological innovations may be helpful. As result, the objective has been set that every young person between the ages of 12 and 18 must be reached by the message about the need to reduce the rates of obesity and overweight in Duval County, Florida by the end of June 2020 (a period of three months). To achieve this, the social media platform that is Facebook has been chosen as the appropriate vehicle with which to reach this population demographic. The choice of this population demographic has been informed by several salient factors. First, the studies reviewed in this paper clearly show that this very age group (adolescents) are the ones that have been very severely affected by the scourge of obesity. Paradoxical Case of Poverty and Obesity – Population Disparities Essay. Secondly, this is the population that mostly uses social media to communicate and interact with the outside world. Third, it is this population that is influential in the family context as even the parents listen to what they advocate for, because of the same reason of being technologically savvy and informed. Targeting this population, therefore, is expected to yield better results than if the parents were the ones that were targeted.
To carry out this strategic communication, health workers in the Duval Community (particularly nurse practitioners concerned with providing primary health care) will be engaged to draft health information about obesity and overweight. After this, several youth who are also in the same target age group will be given the information to disseminate. It is expected that this information will be shared widely among the teenagers within the three months to reach each and every one of them. Also, a Facebook page will be created specifically for this social media campaign. This page will be promoted, meaning that adverts will be paid for to facilitate the dissemination of the message to the population within the geographical area of Duval County, Florida. v
(C2) Social Marketing Interventions
Two social marketing interventions that this strategy is expected to utilise are direct marketing and word-of-mouth marketing. Direct marketing involves the targeted promotion of the messages as has been elucidated above. This means that each and everyone within Duval County with a Facebook account will randomly get the message originating from the Facebook page set to educate about the dangers of obesity and overweight. On the other hand, word-of-mouth marketing relies on the fact that those who will have already seen the message on their Facebook walls will inform others or show them what the message is. This is expected to be spontaneous since friends of the obese teenagers would naturally be eager to help them defeat the condition.
(C3) Description of Social Media Platform
As has been explained above, the social media platform Facebook was chosen because it is the most widely used among the population of concern than any other social media platform or application. Compared to Twitter, Snapchat, Instagram, and Telegram; Facebook has a near universal usage in any given population in the world. It is because of this that the creation of a Facebook page was deemed fit to disseminate the health information about obesity and overweight in Duval County. The hope is that through the sharing button available on Facebook, many of the targeted teenagers will share the story and information to their peers (especially those that are obese), who will in turn also share the same information. Within no time, the intended information will have reached almost everyone that it is supposed to reach. Paradoxical Case of Poverty and Obesity – Population Disparities Essay.
(C3a) Benefits of Social Media Platform
The benefits of social media platforms in the dissemination of health information are immense. For instance, Facebook gives the option of writing unlimited text in addition to adding audio and video media. This is actually one of the most attractive features of the application that make it preferable apart from its wide reach. Others like instagram are mostly based on visual depiction of information such as photos and portraits. If this same information were to be shared via instagram, a poster-like message would need to have been created and posted as a photograph. This, however, would have made it difficult to include detailed information such as is possible with Facebook. As for Twitter, the limited text that one can write would mean that the health message is heavily summarised. This is not desirable, given that the target population is supposed to get clear and self-explanatory information concerning obesity and overweight without having a healthcare expert in front of them.
(C4) Benefit to Target Population
From the information elucidated above, there are many benefits that the target Duval County population will get from this social media campaign about reduction of obesity prevalence. To begin with, they will be able to have the expert information they need to separate fact from fiction. One of the most dangerous things concerning health matters is misinformation. With the correct information, therefore, the population will be able to take the necessary measures such as eating healthy and working out by way of isotonic exercise (walking). Paradoxical Case of Poverty and Obesity – Population Disparities Essay
(D) Best Practices for Social Media
The best practices for social media centre on ethics and morality. In saying this, it is worth noting that social media is not regulated like mainstream media. As such, it is upon the person using the social media platform to exercise self censorship. However, Facebook, for instance, also exercises censorship if another user happens to report your post by finding it offensive. The same situation pertains with Twitter, Instagram, and Telegram. In the case of healthcare information, it is imperative that the information given there is factual to avoid misleading the masses. Doing otherwise would put the lives of many persons at risk, something which is immoral, unethical, and illegal.
(E1) Stakeholder Roles and Responsibilities
Some of the stakeholders in this Facebook social media health campaign on obesity include the contracted family nurse practitioners, Facebook, the teenagers who originate the message, and the innovator who came up with the idea. Respectively, their roles are to draft factual health information on obesity, to advertise the information, to share the information to as many friends as possible, and to involve as many players as possible.
(E2) Potential Public and Private Partnerships
Public Private Partnerships (PPPs) are important in that they help to pull resources together in the hope of realising a common objective for public good. In the case of this social media campaign, the financial outlay was a bit significant. Therefore, the PPP opted for was that involving a local university and the public health department of Duval County. It is these two that provided the funding for the project.
(E3) Timeline
The timeframe will be three months (implementation). Planning and evaluation will take a month each. Put together, the whole project will take five months. Paradoxical Case of Poverty and Obesity – Population Disparities Essay
(E4) Evaluation
Evaluation will involve carrying out a cross-sectional survey using a questionnaire as a data collection tool. Sampling will be random and the exercise will take place during the evaluation month (fifth month). The objective will be to obtain data on obesity and compare it with pre-intervention data to assess effectiveness of campaign.
(E5) Cost of Implementing the Campaign
The estimated cost of this project from planning to evaluation is expected to be USD 5,000.
(F) Reflection on Social Media Marketing
The community health nurse can harness the power of the social media to effectively and affordably pass on health information to a target population. She can for instance sponsor a message on a Facebook page and this will be made to appear on the wall of everyone within the geographical locality she specifies.
(F1) Reflection on Future Nursing Practice
Technology cannot be evaded in the 21st century. Nursing, like all other professions, must therefore use it to its advantage. In future nursing practice, I foresee myself using social media to carry out research affordably in the area of clinical inquiry to enrich evidence-based nursing practice. Paradoxical Case of Poverty and Obesity – Population Disparities Essay
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References
Babey, S.H., Hastert, T.A., Wolstein, J. & Diamant, A.L. (2010).  Income disparities in obesity trends among California adolescents. American Journal of Public Health, 100(11), 2149-2155.
Braveman, P. (2014). What are health disparities and health equity? We need to be clear. Public Health Reports, 129(Suppl 2), 5–8. Doi: 10.1177/00333549141291S203
Duval County, Florida (2012). Community health assessment and community health improvement plan. Retrieved 15 March 2020 from http://duval.floridahealth.gov/programs-and-services/community-health-planning-and-statistics/_documents/chip.pdf
Frederick, C.B., Snellman, K., & Putnam, R.D. (2014). Increasing socioeconomic disparities in adolescent obesity. Proceedings of the National Academy of Sciences, 111(4), 1338–1342. https://doi.org/10.1073/pnas.1321355110
Hammer, D.G., & McPhee, S.J. (Eds). (2018). Pathophysiology of disease: An introduction to clinical medicine, 8th ed. New York, NY: McGraw-Hill Education. Paradoxical Case of Poverty and Obesity – Population Disparities Essay
Shaw, K.A., Gennat, H.C., O’Rourke, P., & Del, M.C. (2006). Exercise for overweight or obesity. Cochrane Database of Systematic Reviews, 4(CD003817). DOI:10.1002/14651858.CD003817.pub3.
Verité Healthcare Consulting, LLC (2015).  Community health needs assessment. Retrieved 15 March 2020 from https://ufhealthjax.org/community/documents/chna-2015.pdf
Wang, C.Y., Gortmaker, S.L., & Taveras, E.M. (2011). Trends and racial/ethnic disparities in severe obesity among US children and adolescents, 1976–2006. International Journal of Pediatric Obesity, 6(1), 12–20. https://doi.org/10.3109/17477161003587774
Zhang, Q., & Wang, Y. (2004). Socioeconomic inequality of obesity in the United States: do gender, age, and ethnicity matter? Social Science & Medicine, 58(6), 1171–1180. https://doi.org/10.1016/s0277-9536(03)00288-0    Paradoxical Case of Poverty and Obesity – Population Disparities Essay

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Population & Community Health Promotion Sample Essay

Population & Community Health Promotion Sample Essay
What are specific actions that health professionals can take regardless of their practice area and site to promote population and community health?

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Population and Community Health Promotion
Specific actions that health professionals can take regardless of their practice area and site to promote population and community health
Planning and implementation Health education programs
Health education is a major approach for implementation of disease prevention and health promotion programs.  Health professionals can plan and implement health education programs to offer education to populations and communities on how they can become responsible for their development and protection of their health all their lives. Population & Community Health Promotion Sample Essay According to Kabasakal and Kublay (2017), health education, which provides structured learning opportunities, partly includes communication approaches projected at promoting health literacy practices, like the increase in the levels of knowledge along with the advancement of life skills to assist improve community and individual health.
Health care education can be offered through sharing of information, as well as motivating and encouraging trust and certain skills, which are influential in bringing improvement to the health of people Population & Community Health Promotion Sample Essay. Kabasakal and Kublay (2017) state that if health care professionals working in institutions that offer primary health care have the necessary skills, experience and knowledge to promote health, they can inform communities by counselling them about appropriate lifestyle behaviors that promote health.
Getting involved assessment of community needs and health planning
Community health planning starts with health professional diagnoses. Health professionals design goals aimed at resolving potential or existing health concerns.  Recognition of potential or specific health issues with premeditated action to attain anticipated outcomes offers the data and framework for community needs assessment.  As Edelman, et al (2017) indicate, community involvement in health planning enables effectual assignment of priorities. As recipients of health services, community members endeavor for services that are high-quality and reasonably priced. Residents intend to attain suitable benefits for the concerns and needs of the populations. Health planning highlights the promotion and protection of population health and thus the definition of problems, actions, and solutions occur at the group level. Population & Community Health Promotion Sample Essay.
Planned change is as a result of efforts by groups and individuals and entails fundamental changes in behavior. Individuals function as agents of their personal health conditions and community health goals usually relay on dynamic decisions to alter their lifestyles. Endeavors to impact and reinforce transformations in community health behavior is the emphasis of effectual risk reduction programs. According to Edelman et al (2017), promotion of community health via risk reduction programs entails community members become more responsible of their personal health, becoming more active in the adoption of healthy lifestyles, and monitoring resources within the community to accomplish healthy behaviors Population & Community Health Promotion Sample Essay.
Advocating for social change
Health professionals can advocate for policies that can improve social conditions which influence the health of disadvantaged and poor populations.   Economically and socially disadvantaged populations have a less likelihood of being in good health, less likelihood to access quality healthcare services and a high likelihood of dying prematurely compared to economically and socially advantaged populations. According to Williams et al (2018), economically and socially disadvantaged populations are greatly affected by public policy and can thus gain from policies intended at improving social conditions that influence health. Nurses, physicians, and other health professionals can advocate for the proper social policies to promote fairness, justice and health parity and adequately, addresses social determinants of health.
Health professionals have an influential voice and can s articulate on the health effects of social challenges to inspire wider policy responses and impact what goes onto the local agenda. As Andermann (2016) alleges, health professionals can participate in activism through supporting political parties and social movements that lobby for affordable childcare, progressive taxation, basic income, along with other measures to lessen health disparities. they can undertake locally pertinent research and utilize data on social determinants intercede in their personal context in a better way and produce evidence as a pedal for advocacy. Williams et al (2018) claim that the appropriate policies and right interventions can interpose the cycle of disadvantage, poor health, and poverty. Evidence-based, effectual policies can result in healthier communities and tackle inability to access material and social resources that act as the source of health inequities Population & Community Health Promotion Sample Essay.

References
Andermann, A. (2016). Taking action on the social determinants of health in clinical practice: a framework for health professionals. Canadian Medical Association Journal, 188(17-18): E474-E483.
Edelman, C., Mandle, C., & Kudzma, E. (2017). Health Promotion Throughout Life Span – E-Book.  New York:  Elsevier Health Sciences.
Kabasakal, E., & Kublay, G. (2017). Health Education and Health Promotion Skills of Health Care Professionals Working in Family Health Centers. International Journal of Medical Research   & Health Sciences, 6(3): 22-28.
Williams, S., Phillips, J., & Koyama, K. (2018). Nurse Advocacy: Adopting a Health in All Policies Approach. The Online Journal of Issues in Nursing, 23(3): 1. Population & Community Health Promotion Sample Essay

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Patient Protection and Affordability Care Act Health Policy Paper Sample essay

Patient Protection and Affordability Care Act Health Policy Paper Sample essay
Abstract
The purpose of this research is to identify the significance and impact of the Patient Protection and Affordable Care Act and how health care insurance plays impacts millions of American citizens. The significant aspect of this paper will show readers the overall picture on how Medicare helps individuals in need and what group of people this act is for and the people who are against it. Research in this paper will show that the main argument is making health care affordable for everyone to make sure they have the proper treatment in order to seek medical attention and receive medication. Research came from empirical journal articles dealing with this particular act and how it impacts American citizens. Results suggest that mainly the reason for this act is to provide comfort for not only the geriatric population but also anyone who is need of help for funding when it relates to medical insurance. Changes that should be implemented should show the underlying cause of tax increases on the middle class, affordability for all who qualifies, and ways to improve health care coverage for the next forty years.
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Introduction of Problem/Issue and Related Bill
The Patient Protection and Affordable Care Act is one of the most important bills to be introduced and implemented because it covers a important topic in America today which is healthcare and how citizens of this great country can benefit from being covered medically in certain situations The Affordable Care Act is targeted at increasing the reasonable pricing and how health insurance coverage for Americans is rated. The main issue focused on this bill is to reduce the long term costs of health care not just for individuals but also the government. The Affordable Care Act was enacted by the 111th United States Congress and was effective on March, 23, 2010. The United States representative for New York’s 13th congressional district Charles B. Rangel introduced the Affordable Care Act in the House as “Service Members Home Ownership Tax Act of 2009” back in September of 2009. The act was passed by the House in October of 2009, and then passed by the Senate in December 2009 under the title that it goes by today known as the Patient Protection and Affordable Care Act. The bill was signed into law by President Barack Obama on March, 23, 2010. I feel the main issue with this bill is making sure there is a way that all American citizens can be covered by medical insurance that is fair for each class depending on your income and that it is affordable when situations arises and medicine or medical attention is required. Patient Protection and Affordability Care Act Health Policy Paper Sample essay.
“Nearly 30 years after President Nixon proposed the first major overhaul of the health care system, comprehensive reform became a reality when President Obama signed the Patient Protection and Affordable Care Act (ACA) on March 23, 2010. The ACA is expected to cover 32 million currently uninsured people by expanding Medicaid, offering subsidies to purchase insurance, and prohibiting preexisting condition exclusions. Like Presidents Carter and Clinton before him, Barack Obama campaigned on a promise of health care reform.” (Gostin & Garcia, 2012) The significance of the bill shows why it is so important in society today. The main concern is finding the problem and what is wrong with the influential parameters that the bill puts upon people. The following section shows how the bill was introduced and also certain issues that relate to it and how particular situations of everyday life impact the bill.
“On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act (PPACA).” This Act is a major attempt to improve access to health care by expanding coverage through Medicaid and by reforming the private insurance market. Quality is also an important focus of PPACA—it promotes disease management, care coordination, new payment models, value-based purchasing initiatives, and the use of comparative effectiveness research. PPACA offers a strong regulatory push toward the goal of “flawless execution,”   the health care equivalent of zero defects in industrial production.” (Furrow, 2011) I think this act is one of the most important acts in the history of America because of the impact it has had on the healthcare industry and also how it impacts so many people on a daily basis and continues to be the leading force to make health care affordable for all people here in the United States.

Background/Significance and Scope of the Problem

The most unique aspect of the Patient Protection and Affordable Care Act is how it became known as what it is today. The name that is known as the bill itself today has undergone changes that can control health care costs and public insurance being expanded by way of insurance expansion that consist of Medicare and Medicaid availability. The one change starting out was the notion that private insurance had to be in a nutshell regulated and subsidized. Most of the ideas that started the Patient Protection and Affordable Care Act makes up the foundation of the expansion of the laws insurance and in past initiations have been bought up in reform proposals. Ideas and opinions have been expressed since the conception of the new law for healthcare for private insurance versus public insurance when it comes to individual mandates paired with sums of money from the government. Patient Protection and Affordability Care Act Health Policy Paper Sample essay.
This act or notion was thought of in a way that United Health Insurance could eventually win the backing from Senate. Experts that are well educated on healthcare policy came to the conclusion based on theory that the individual mandate of the requirement started with Republicans over twenty years ago to buy health insurance when back then it was proposed at first by the politically conservative Heritage Foundation as a other option to just one person paying for health care. This mandate was pushed heavy by Republicans back then as the ideal approach at first to health-care reform basing it off of one thing: responsibility placed upon the individual. In 1986, the Emergency Medical Treatment and Active Labor Act pass by both parties in the Congress and signed by then President Ronald Reagan focusing on Medicare. This act require all hospitals that have a partnership with Medicare to provide emergency care to any patient who seeks medical attention, making the government take the cost that didn’t have the funding to pay the medical expenses.
“PPACA contains numerous provisions that fund research and disseminate findings to providers about what works. Some provisions define health care quality and its measures, while others attempt to generate new research findings on outcomes and best practices in the clinical setting. Still other provisions mandate broad dissemination of these findings to providers and consumers of health care through websites and other media. Finally, payment strategies will be expanded and tested to determine how the Medicare payment system can better promote best practices and outcomes.” (Furrow, 2011) There are a lot of issues that correlate with the Patient Protection and Affordable Care Act but none is bigger than the impact the act has on Medicare.
The first way this issue impacts the act as whole discusses preventive services for people eligible for coverage. Medicare was put in place to cover more services for people that need preventive screenings done annually. The most influential act of 2003 was the Medicare Prescription Drug, Improvement and Modernization Act that states the enrollment period in Medicare Part B a person can receive a physical examination. The next part of Medicare that deals with the ramifications is prescription drugs and the cost of medicine for people that have Medicare. This part of the deal requires participants to pay twenty five percent of the prescription drugs cost. One would suggest that this can be very impactful because of the substantial amount of money that can be saved but also how much is needed to make sure medical problems are at ease.
“First Lady Michele Obama highlighted some of the most welcomed provisions: “Insurance companies can no longer discriminate against children and adults because they have a preexisting condition. Patients can no longer be dropped by their insurance companies because they get sick. People suffering from a serious illness like breast cancer can focus on their treatment because they no longer have to worry about hitting their lifetime limit on coverage. And college kids and young adults just starting out on their own can now get coverage through their parents’ plan. Preventative services are now covered at no out-of-pocket costs. Things like mammograms, cervical screenings, colonoscopies, childhood immunizations, prenatal and new baby care, high blood pressure treatment, all of these are included in new insurance plans with no deductable, no copay, no coinsurance, nothing. Patient Protection and Affordability Care Act Health Policy Paper Sample essay. These steps are crucial because they can help combat preventable conditions that can have serious health consequences later in life.” (Ober & Craven, 2011) The most important aspect to understand that any type of medical condition won’t be judged upon as a factor in the decision when impacting insurance companies in regards to health care reform. Society today has become very strict on certain laws and ways to prevent people from getting the coverage they need, but this Affordable Care Act makes it more relatable for people dealing with the new health care reform. There are many considerations that impact the act from standpoints that influence social, economic, political, and ethical considerations.
“In terms of the overall economic effect, the ACA will expand coverage to tens of millions of people (the White House estimates 32 million) which will naturally increase demand for health-services and boost health expenditures like hospital visits and medications. This increased spending should fuel growth, at least in the near-term. The legislation is financed partly by additional taxes, especially on higher-earners and their investment income. Patient Protection and Affordability Care Act Health Policy Paper Sample essay. The tax hit could stifle consumer spending, offsetting the jump in health expenditures. Then again, Americans with higher incomes tend to save more cash, so it’s also reasonable to think taxing them could divert money from savings accounts to spending — boosting the economy. The overall macroeconomic effect will most likely not be discerned as positive, negative or neutral for some time.” (Norris, 2012)
ACA really displays how not only money will be impacted for years to come but also the impact on so many people. The ACA in demand for health resources will most definitely take the health care industry into new heights never seen before. The dilemma comes into play when taxing the wealthy and sticking the middle class and less fortunate with higher taxes on consumer products that they can’t afford making the health care industry flourish. The social impact on this act can really impact elderly and their daily functions of everyday life and daily living. Socially geriatrics is probably the only group of people that this act impacts due to living normal productive lives after the age of sixty five and beyond. Social aspects can impact parents with children who are on Medicare dealing with insurance that tends to be on the high end of the monetary side. Children who are just born that have to deal with the different situations socially are impacted not by the act in regards to covering them but how people conceive them on a daily basis. Patient Protection and Affordability Care Act Health Policy Paper Sample essay.
“The mostly hotly debated economic factor is how the ACA will affect the deficit. As President Obama reminds anyone who will listen, the Congressional Budget Office scored the legislation as a net deficit reducer (to the tune of $140 billion) over the next ten years although conservatives have quibbled with how the bill was scored. The Court ruled on June 28th that the Federal government cannot force the states to expand Medicaid as the bill had originally intended (specifically, the Federal government could revoke a state’s entire allocation of Medicaid funding if it did not expand Medicaid coverage) so it is possible that conservative governors will not move ahead with expanding Medicaid since they are no longer compelled to. This, no doubt, would be a huge factor in both Federal and state budgets.” (Norris, 2012) The most impactful is how this will deal with the deficit that the United States is already in and will be in for years to come. One would think Obama informing everyone about the Congressional Budget Office is supposedly a net deficit reducer for years to come but from the prior statement who knows if that is even true. The economic impact of the ACA is so substantial that the list goes on based upon factors that make the economy landscape impacted by the Affordable Care Act.
“Regarding the economic topic of the day, job creation, the effect of the legislation again, is hard to read. As noted above, spending in the health sector is likely to increase if for no other reason than tens of millions more consumers in the market so it is not unreasonable to assume jobs will be created in the health sector. Patient Protection and Affordability Care Act Health Policy Paper Sample essay. On the other hand, there is much anecdotal evidence (though little empirical, since the Act’s main provisions are not yet in effect) of businesses downsizing or putting off hiring because of the new employer-provided insurance regulations. The incentive and regulation structure for businesses is complex though, with varying rules and subsidies depending on the size and nature of the business so it is hard to forecast how hiring in the private sector at-large will change if at all.” (Norris, 2012)
That is why the most sought after jobs in the market today are all related to the health care field because so many different options can be explored amongst health care positions. Health care is so wide that any job you get within the health care field one can always work its way up from transitioning to a better job or doing what it takes to learn more job functions that will better place you in a more prominent role. The political implications toward this bill are still in progress because the government has its pros and cons towards the bill and that is what is making Congress go through the things they have been going through since the acts inception. Political issues range in variety of ways from having President Obama name it Obama care and helping American citizens deal with Medicare and having the chance to pay for medical expenses. The most bizarre circumstances going on even now dealing with the provisions and updates is how Congress is dealing with the issue and how the house and senate are going about their decision making in the middle of the process. Patient Protection and Affordability Care Act Health Policy Paper Sample essay.
Ethical implications stir up mix emotions from local all the way up to the national levels of hierarchy. People feel that with this act their government officials only help people that are in the rich class or over a specific age requirement and makes it harder for people who don’t fit a certain criteria to not have any say so whatsoever. Ethical considerations must be made for parents young having kids in their teens, people on disability shouldn’t have to fight for getting approved for Medicare and Medicaid at all in any situation because the one thing that everyone needs is health care insurance to cover bills and medications. The Patient Protection and Affordable Care Act causes a stir amongst people who are for it and people who are against it, but the question is what are people take on the act and how does it impact them on a daily basis.

Proponent and Opponent Arguments
Life will give you a lot of aspects and one thing is for certain, you will either agree with it or disagree with it. The same can be said about the Patient Protection and Affordable Care Act that is currently in place. The group of people that are interested in the act is the everyday hard working man and woman who have a family to take care of and provide especially when it comes to health care funding. This act helps families and businesses alike to have health care coverage in place and also ways for them to get health care coverage if needed. People that are for it are also people with pre-existing health conditions.
These group of people can’t help their health is in jeopardy so they always can rely on this particular bill to be implemented for their benefit. Americans can be at ease and know that insurance companies are held accountable for rate increases and trying to con citizens who are hard working and doing what is right. Health companies can’t cancel your health insurance at all if you so happen to get sick which is something no one can prevent from happening. The reason it benefits families because you get to pick your choice of doctor no matter what and allows you to receive free preventive screenings that can come beneficial for you in the long run to catching something before it becomes worse. College students are for this act as well because they can stay on their parents insurance until they are twenty six which is good because most young people form eighteen up until close to twenty six are pursuing their degree, masters degree, and then a good paying job that will benefit them from a monetary standpoint.
The group of people who are against the Patient Protection and Affordable Care Act is mostly government officials and members of both the Republicans and some of the Democrats as well. The main issue from a political standpoint is based off the taxes and who gets taxed the most from this act and who it benefits the most. The middle class thinks it is unfair to tax them based off what they make more than the rich people who have the money and get taxed less. Rich people feel that they worked hard and it is not fair to get tax more than the middle class. Health care insurance agencies are against it when it comes down to the fact of money and who does it benefit the most between them and their clients. Health care providers can be a part of this group to because they always seem to be up to something that is not accurate or fair for their clients when they are trying to pursue health care coverage and benefits. One can argue that the PPACA really values what is known as patient safety and has implemented provisions in place for patients. The provisions in place really should show people who are for it and for people who are also against it what really matters first and that is patients. Patient Protection and Affordability Care Act Health Policy Paper Sample essay.
“The passage of PPACA promises to take patient safety to the next level of regulatory intensity in American health care delivery, in part through the infusion of money into patient-safety research and into payment reforms in particular. PPACA has an astonishing variety of provisions aimed at improving the quality of the U.S. health care system, reducing errors, and generally promoting patient safety. These provisions include new centers, demonstration projects, and funding awards for a wide range of quality improvement initiatives. The Act sets out an ambitious research agenda for the United States and provides funding and other incentives to accomplish its goals. It establishes a mandate of continuous, .data-driven testing of the performance of health care professionals and facilities Patient Protection and Affordability Care Act Health Policy Paper Sample essay. It also launches “demonstration projects” through which the federal government funds particular forms of health care or health care delivery systems with a requirement that their performance be studied, often with the intent of examining their potential for wider adoption.” (Furrow, 2011) I think that the Patient Care and Affordability Act can be a force upon acts that have been implemented in the history of our country because of the nature of what is at stake and that is the assurance of health care coverage for all American citizens in the United States. Human Services plays an important role in the Patient Protection and Affordable Care Act because it focusing on impacting people in every form of patient interaction.
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Human Services Perspective
As a human services student, I feel it is very important that the Patient Protection and Affordable Care Act are implemented to insure patients with the best services available in regards to healthcare coverage. One can argue that human services representatives are the first group of people that patients come into contact with in regards to services that are available to them and what is the best option to take amongst people needing health care. Human services look at how health care can impact people in need of benefits and medical expenses and also focus on the positive traits the act offers individuals.“First, the Act provides individuals with improved access to clinical preventive services. A major strategy is to remove cost as a barrier to these services, potentially opening new avenues toward health. For example, new private health plans and insurance policies (for plans or policy years beginning on or after September 23, 2010) are required to cover a range of recommended preventive services with no cost sharing by the beneficiary. Second, the law promotes wellness in the workplace, providing new health promotion opportunities for employers and employees. For example, the Act authorizes funds for grants for small businesses to provide comprehensive workplace wellness programs.” (Koh & Sebelius, 2010) Human services start with showing clients what can be offered for them in any situation and having direct access with clinical preventive services needed by anyone that seeks medical attention. Human services representatives can help with funding sources and dealing with helping patients find different references to help with the cost of anything medical in the health care industry. Human services definitely will impact the workplace and how workers are handled with health care benefits and coverage for employees. For example, Carolina Healthcare System being the biggest healthcare provider in North Carolina provides wellness programs that benefit employees and help them save money in the long run through different types of programs focused on the wellness aspects. These are two of the components that the act can do for individuals and the other two focuses on the community aspect and how human services can impact a patient life through their perspective communities.
“Third, the Act strengthens the vital role of communities in promoting prevention. New initiative opportunities are designed to strengthen partnerships between local or state governments and community groups. For example, new Community Transformation Grants promise to improve nutrition, increase physical activity, promote smoking cessation and social and emotional wellness, and prioritize strategies to reduce health care disparities. Fourth, the Act elevates prevention as a national priority, providing unprecedented opportunities for promoting health through all policies. For example, a newly established National Prevention, Health Promotion, and Public Health Council, involving more than a dozen federal agencies, will develop a prevention and health promotion strategy for the country.” (Koh & Sebelius, 2010) The important component is having communities promote prevention in every regards when it comes to health and the overall goal of the Patient Protection and Affordable Care Act. The relationships between state and government have to include the services of Human Services representatives to bridge the gap and come to an understanding. National attention must be made aware of this bill because of the impact and significance it will have on this country for years to come but really because of the promotion to everyone that prevention and health promotion is the way to go for all Americans can be more alert about their health. One would agree with the Patient Protection and Affordable Care Act because of what it means to not just me but all citizens in need of reassurance of their health care status.
Policy/Bill Recommendations
“This act is the largest reform in health policy in the United States in more than 40 years and thus controversy regarding its implementation and potential for effectiveness will continue. Nurses have the opportunity to engage in the policy implementation of the PPACA through fellowships such as the Health and Aging Policy Fellowship, sponsored by Atlantic Philanthropies, and the Robert Wood Johnson Policy Fellowship. These are critical positions for professionals to work with federal and state administration and legislative branches of government and directly impact policy design and regulatory action. Geriatric nurses will be in the forefront of the potential these changes will have on improving the quality of care older adults received.” (Brody & Sullivan-Marx, 2012) Brody and Sullivan-Marx said it best about this act being the largest reform for the United States in the last forty years is a major accomplishments and shows how far the country has to go to even improve from here on out. I feel that this bill should be passed because of the importance of the overall bill and what is needed for Americans which is affordable health care where anyone can go to the doctor and afford their bills and be able to get the medication that is needed without any problems. The only recommendation I would advise is dealing with the tax situation and making it fair for all individuals not just the rich or poor but a well balance effort. The Patient Protection and Affordable Care Act is one of the most prominent and successful acts that will forever go down as a force that changed the landscape of the health care industry for Americans around the world. Patient Protection and Affordability Care Act Health Policy Paper Sample essay.
References
Bondurant, E. J., & Henry, S. D. (2011). Constitutional challenges to the patient protection and affordable care act. Defense Counsel Journal, 78(2), 249.
Brody, A., & Sullivan-Marx, E. M. (2012). The patient protection and affordable care act: Implications for geriatric nurses and patients. Journal of Gerontological Nursing, 38(11), 3. doi:10.3928/00989134-20121008-01
Duhaime, S., Villarreal, A., Young, J., & Holt, G. R. (2012). Patient protection and affordable care act and physician’s assistants. Southern Medical Journal, 105(11), 583. Patient Protection and Affordability Care Act Health Policy Paper Sample essay
Furrow, B. R. (2011). Regulating patient safety: The patient protection and affordable care act. University of Pennsylvania Law Review, 159(6), 1727.
Gostin, L. O., & Garcia, K. K. (2012). Affordable care act litigation.(patient protection and affordable care act). JAMA, the Journal of the American Medical Association, 307(4), 369.
Harrington, S. E. (2010). U. S. health-care reform: The patient protection and affordable care act. The Journal of Risk and Insurance, 77(3), 703-708. doi:10.1111/j.1539-6975.2010.01371.x
Hyman, W. B. (2012). An explanation of the patient protection and affordable care act. Ohio Northern University Law Review, 38(2), 579.
Joyce Pulcini. (2013). Update on the patient protection and affordable care act. The American Journal of Nursing, 113(4), 25.
Kizer, K. W. (2012). Veterans and the affordable care act. JAMA : The Journal of the American Medical Association, 307(8), 789-790. doi:10.1001/jama.2012.196
Koh, H. K., & Sebelius, K. G. (2010). Promoting prevention through the affordable care act. The New England Journal of Medicine, 363(14), 1296-1299. doi:10.1056/NEJMp1008560 Patient Protection and Affordability Care Act Health Policy Paper Sample essay.
Norris, S. (2012, August 27). The affordable care act and the economy. Retrieved from http://americaandtheglobaleconomy.wordpress.com/2012/08/27/the-affordable-care-act-and-the-economy/
Ober, S., & Craven, G. (2011). The patient protection and affordable care act: The opportunities for nurses. Journal of Infusion Nursing, 34(1), 20-21. doi:10.1097/NAN.0b013e3182028915
Singer, S., & Shortell, S. M. (2011). Implementing accountable care organizations.(patient protection and affordable care act). JAMA, the Journal of the American Medical Association, 306(7), 758.
Tanner, M. (2013). The patient protection and affordable care act: A dissenting opinion. Journal of Family and Economic Issues, 34(1), 3-15. doi:10.1007/s10834-013-9350-7
Health Policy Issue Paper Grading Rubric

Student Name:                            Course/Section:                            Date:

Criterion
Points Possible
Points
Earned
Instructor Comments

·         Problem/issue briefly discussed
·         Related legislation/bill identified
·         Name and number of bill provided
·         Individual who introduced bill noted
·         Current status of bill given (i.e., in committee, passed by house, etc.)
·         Main headings included
30

Patient Protection and Affordability Care Act Health Policy Paper Sample essay

·         History of bill, initial development and impetus for introduction of bill, etc. discussed
·         Pertinent literature review relevant to issue/problem included (i.e., if bill is related to the issue of HIV or teen pregnancy, present literature that validates this problem)
·         Social, economic, political, and ethical considerations/impact related to issue discussed
50

·         Proponents (interest groups/individual) of bill listed and position discussed
·         Opponents (interest groups/individual) of bill listed and position discussed
40

·         “Nursing” OR “human services” perspective on the issue and related bill presented
·         Internet, journal sources used (i.e., see role of Advanced Practice Nurses (Hamric)); ANA position statements, human services oriented institutions, organizations; Virginia Nurse Practice Act; Code of Ethics for Nursing, etc.)
·         Personal views about issue/proposed legislation given
50

·         Expanded on comments about the bill given in the introduction (may include actual bill document retrieved from Internet as an appendix)
·         Student recommendations if bill should be passed in current form discussed (why/why not)
·         Student recommendations for revision of elimination given
50

·         Current APA formatting
·         Correct spelling, grammar, and sentence structure used
·         Flow of ideas are well organized, coherent, and thorough
30

Total
250

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COMMUNITY HEALTH ASSESSMENT ANALYSIS SAMPLE ESSAY PAPER

COMMUNITY HEALTH ASSESSMENT ANALYSIS SAMPLE ESSAY PAPER
Purpose
You will create an analytical summary which provides a summary of the major issues affecting your community’s health and quality of life, with particular relevance to your assigned aggregate clinical group. The emphasis should be on writing a quality analysis that highlights your ability to collect and critically interpret the raw data to make recommendations for your community.
NB// THE FOCUS neighborhood/ placement site is York University Heights
Headings:
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Introduction and Purpose – Briefly describe the focus of your Community Health Assessment in relation to your particular neighborhood/ placement site (York University Heights )
Data Collection Methods – Describe the methods used and your rationale for choosing those methods. Discuss the strengths and/or limitations of the key methods used as you have experienced them in your community health assessment.
Key informants consulted – Identify who the informants are (no real names are needed), how you have involved them as collaborators in your community assessment. As well, explain why you see them as important partners for health planning and for your health promotion endeavours in the community
Diagnosis of community health issue – Identify and discuss 2-3 key social determinants of health that impact the health and/or quality of life of your aggregate population . Clearly describe one actual or potential health issue faced by the aggregate population; this health issue should flow logically from your analysis of the social determinants of health that impact the community.
Suggestion of two preliminary recommendations to address the identified health issue. Each recommendation should be evidence-based and supported by no less than two academic references. As well, the recommendations should take into consideration the strengths and capacities of the community. While your praxis group may not be able to implement these recommendations with the community due to time restraints, these recommendations should provide realistic and relevant suggestions for how the health of the aggregate population can be improved through addressing the identified health issue. COMMUNITY HEALTH ASSESSMENT ANALYSIS SAMPLE ESSAY PAPER
Conclusion. Provide a strong and succinct conclusion to highlight the key message you want to deliver to the potential audience (e.g. city Councillors, community residents) based on the findings of your health assessment and their implications for promoting community health.

Analysis of Community Health Assessment

Analysis of Community Health Assessment
Introduction
The duration of existence of any human being is ultimately determined by the extent of physical care that they extend to their bodies. There is a unique interaction that exists between the health status of a person and the quality of their immediate environment. The society or community that a person belongs to has a lot of significant importance when it comes to ascertaining where the members of that area live or reside in a decent environment. This explains why the study of community health holds a lot of importance as it strives to ensure that people live in places that promote and prolong their existence. The analysis and evaluation into a given community can be able to provide credible information on their state of health as well as some of the most pressing concerns. This paper is an essay that provides a community health assessment of the York University Heights in terms of the vital aspects that affect most individuals in the area.
Neighborhood and community of focus: York University Heights.
Body of the Essay

Data Collection Methods

The York University Heights is one of the common neighborhoods in Toronto and it is home to people who are from diverse descents. This community is known to host immigrants from Italy and China as well as many Jamaicans and Indian residents. This makes this location a very interesting one when it comes to evaluating the state of health of its members. The main data collection methods that were used in this assessment entailed the use of secondary sources where a lot of qualitative data was used. This method relied on already published papers and articles to collect information about the York University Heights community.
These sources indicated that the majority of people in this community fell under the age bracket of between 25 years and 64 years. The rest of the population were mostly young children and the youth that accounted for the smaller percentage. This method of data collection focused on obtaining information that was relevant to the study of the health of the community (Adano, 2016). Hence, a lot of details that were gathered revolved around knowing the number of ethnic groups in the area, their age, status of residency, marital status, number of people in one household as well as the income of the parents. Additionally, data was collected in relation to how much money a given family spend on housing and how much was specifically allocated to food.
The secondary methods of collecting data also obtained information regarding whether people of the York University Heights community were satisfied with their current standards of living. This method was also combined with one primary strategy of collecting data so as to ensure that the study remained credible (Waitzkin, 2016). This involved interviewing a number of people in the community as well as issuing questionnaires that aimed at gathering information on the most important aspects of their health. The reason why both primary and secondary sources were combined in because they are some of the most reliable ways to collect data. What’s more, secondary sources rely on information that has already been approved by other researchers and this makes it more valid (Carey and Crammond, 2015). COMMUNITY HEALTH ASSESSMENT ANALYSIS SAMPLE ESSAY PAPER
Likewise, primary sources provide first-hand information about a given issue and in this case, they helped in strengthening the results obtained from secondary sources such as publications and articles (Crammond, 2014). The use of interviews in this community health assignment was very instrumental as it provided a lot of details in regards to the York University Heights people and their ways of life.

b) Key informants consulted

The people that were chosen from this study were chosen from each of the ethnic communities present in the York University Heights location. This people were also selected based on their age where the inclusion criteria meant that they had to be above 25 years of age. These people were deemed valuable to the study as they had lived in this place for quite some time. What’s more, their educational backgrounds showed that they had an inclination towards community and public health. This is a positive attribute that ensured that it would be much easier to undertake the assessment with them. Additionally, they formed important partners for the process of promoting better health in the York University Heights community as they understood the ways of life of most people.

c) Diagnosis of community health issue

The majority of people that live within the York University Heights were shown to face a number of health issues that were brought about by their immediate community. These challenges closely relate to the social determinants of health that deal with the string forces and systems that shape the life of a person (Schroepfer, 2016). Most commonly, these forces are present in the community that people are based as well as their areas of residence. The three social determinants of health that affect the people living in York University Heights includes their level of income, access to medical care as well as standards of living.
These three factors impact on the health of most people in this area and the community at large. The survey that was conducted showed that most people living in this region earned less than ten dollars on a daily basis. This amount is too little to cater for their household needs or even allow the members to live comfortably. A low income status is a serious deterrent to health because it means that people cannot afford enough food, decent living or even access quality health care (Schifferdecker and Bazos, 2016). Moreover, it also means that their dependents may not have access to the best quality education and this can affect them in the future.
The same case was seen in the York University Heights community where people that had lower incomes spend more on housing and food such that there was little money left to cater for education. Secondly, the access to medical care was shown to be a huge problem according to the information gathered from questionnaires and interviews. The results showed that most of the people could not be able to afford health care because of their low income. Additionally, others could not also afford to pay for their medical insurance because it would mean cutting down on some household expenses.
The issue of health care was also shown to be a major problem because people were accorded medical attention based on their ethnic affiliation. The third social determinant of health is the living standards of most people in York University Heights that was mostly influenced by their marital status, number of dependents and even the amount of disposable income that they had. A large percentage of people in this community stated that they were not comfortable with their current status of living. These individuals gave the main reasons for this as lack of a stable source of livelihood, family issues and even lack of government support through subsidies. All these three social determinants have an impact on the health of the people in York University Heights because it affects their ability to afford a decent diet and eve access medical attention whenever they want. COMMUNITY HEALTH ASSESSMENT ANALYSIS SAMPLE ESSAY PAPER

d) Suggestion of two preliminary recommendations to address the identified health issue.

There are a number of viable suggestions and recommendations that can be made in regards to the health issues facing the York University Heights community. The first way of solving the medical issues facing the community is by providing alternative ways that would ensure people are able to afford decent health care (Osiecki, 2016). This can be done through the introduction of policies and packages that cam make medical insurance affordable.
Alternatively, the health department within this area can choose to offer incentives that would motivate the people to seek proper and high quality medical care. The implementation of these suggestions can be a challenging and tricky task, but is could also see an end to the problems facing the community (Osiecki, 2016). Perhaps the people involved should lobby for support from their government so that enough financial resources are made available to introduce subsidy programs as well as affordable medical insurance policies.
Conclusion
The study of community health is an important academic field that focuses on analyzing how people are able to live and interact safely in their places of residence. The focus on the York University Heights as the chosen community provides a lot of information regarding the social determinants that affects their physical health. The access to medical care, level of income as well as the standards of living are the common issues that face people in this community. The fact that most people do not have a decent income means that they cannot afford quality meals or housing. Likewise, the access to medical services is limited due to the fact that most people in York University Heights lack insurance covers while others cannot afford it altogether. The most plausible recommendations for this issue is to introduce policies and programs that will supplement people’s income as well as subsidize medical care so that it is made affordable for all. COMMUNITY HEALTH ASSESSMENT ANALYSIS SAMPLE ESSAY PAPER.

References
Adano, G. (2016). Still Special, Despite Everything: A Liberal Defense of the Value of Healthcare in the Face of the Social Determinants of Health. Social Theory & Practice, 42(1), 183-204.
Carey, G., & Crammond, B. (2015). Systems change for the social determinants of health. BMC Public Health, 15(1), 1-10. Doi: 10.1186/s12889-015-1979-8
Crammond, B. (2014). Help or hindrance? Social policy and the ‘social determinants of health’. Australian Journal of Social Issues (Australian Social Policy Association), 49(4), 489-507
Osiecki, K. M. (2016). Collaborating to Solve Complex Environmental Health Issues in Our Communities. Journal Of Environmental Health, 78(7), 32-33.
Schifferdecker, K. E., & Bazos, D. A. (2016). A Review of Tools to Assist Hospitals in Meeting Community Health Assessment and Implementation Strategy Requirements. Journal Of Healthcare Management, 61(1), 44-57.
Schroepfer, E. (2016). Professional Issues. A Renewed Look at Faith Community Nursing. MEDSURG Nursing, 25(1), 62-66
Waitzkin, H. (2016). John D. Stoeckle and the Upstream Vision of Social Determinants in Public Health. American Journal Of Public Health, 106(2), 234-236. doi:10.2105/AJPH.2015.302936 COMMUNITY HEALTH ASSESSMENT ANALYSIS SAMPLE ESSAY PAPER

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Mental Health Case Study – gender identity disorder sample essay

Mental Health Case Study – gender identity disorder sample essay
Mental Health Case Study
This paper is an essay that evaluates a fictional clinical case and provides solutions based on a sampled medical and mental condition.
Case Study-Paulee.

Response

How would you respond to Semara in trying to help her be assessed by a professional given   what sounds like an emergency situation? (3 marks)
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Paulee is a patient who is suffering from gender identity disorder and this condition has affected her emotional and mental well-being. This lady believes that she is supposed to be a man and her thoughts have clogged her mind such that she has developed suicidal tendencies. The best approach of responding to such a situation is to try and reach out to her through other people who are either transgender or are activists of such issues (Carabez and Scott, 2016). Mental Health Case Study – gender identity disorder sample essay.
The process of relating to a person who is struggling with the same issue is known to be therapeutic and it can even help Paulee to heal from depression and even drop her suicidal thoughts.  This people can also convince her to accept to talk to a professional because her cutting stints are an indication that she is definitely in an emergency situation (Chapman et al, 2012). I believe that communicating with the transgender community and also seeking professional help can really save Paulee from taking her own life. Mental Health Case Study – gender identity disorder sample essay.

Form(s)

What form(s) would she be admitted into the hospital under and why? (3 marks)
The above response is one of the approaches that can be used to persuade or even influence Paulee to seek help from a professional counselor or medic regarding her present medical condition. However, it is possible that she may not play along with the plan or even agree to visit the hospital. Hence, it would be critical if some other form of intervention is used since even her partner has been unable to check her into a medical facility. One of the ways to get Paulee into the hospital is by sedating her. Mental Health Case Study – gender identity disorder sample essay.
The latter is one option that can help in this scenario as the patient often gets violent and throws dangerous objects at people  (Faught, 2016). As such, the patient deserves to be in an incapacitated state where she is not in control and can be carried by others. Mental Health Case Study – gender identity disorder sample essay. Alternatively, Paula can also be anesthetized and then taken to the hospital (Levitt, 2015). This means that she would be unconscious for sometime and this would allow her partner as well as the physician to  transport her to a medical facility with ease.

Conditions/Concerns

What type of condition(s) do you think that Paulee has and what are your concerns? (3 marks)
I believe that Paulee is possibly suffering from gender identity disorder, which is a condition where a person believes that their sex does not match with the gender they have. Further, this type of condition is known to manifest in people who believe that they were born as the wrong person and they require to transition to another form in order for them to accept themselves  (Lim and Bernstein, 2012). Mental Health Case Study – gender identity disorder sample essay. This is the same scenario that has affected Paulee because she keeps on cutting herself around her inner thighs and this reflects that she believes she was supposed to be a man.
Additionally, the depressive state that this patient often suffers from could be a symptom of dysphoria where the person feels as though they are in a distressful situation. Dysphoria is known to affect most people who are struggling with transgender issues because they feel that they are not satisfied with the identity of their gender (Roller et al, 2015). Consequently, they begin to develop serious thoughts that if not treated deteriorate to become suicidal and depressive in nature. Paulee is suffering from these two conditions that and she ought to seek medical attention in order to save her life.

Nursing Care

What type of nursing care would you try to provide for Paulee if she was admitted to your unit? Think about the priorities of care as well as on-going care within the unit (6 marks)
The best form of nursing care that Paulee deserves to get is the personalized care where the patient gets to be assisted by a medical personnel in a different way from the conventional diagnose-treat approach. Personal care centers its efforts on making sure that the patient can be able to be attended to by the nurse at all times and in an all-rounded manner (Margolies, 2014).
The nurse in this case should be able to offer Paulee much more than the usual medicines. One way of going about it is trying to establish a connection with the patient so as to understand what troubles them deeply. From here, the nurse can be able to know how to help them deal with their depressive thoughts such as encouraging them to think positively and embrace themselves (Margolies, 2014). The nurse could even offer advice in case they have worked with transgender patients before so that Paulee can be able to relate.
It would also help to keep motivating the patient by helping them to focus on their good sides and achievements in life. In so doing, this person can be able to look above her gender identity disorder, her disability and even relationship troubles so that she can heal much faster. Personal care in nursing has been known to yield positive results as the patient often feels that her troubles, concerns and worries are taken up by another individual who is equally anxious and desires to see them get better by the day. Mental Health Case Study – gender identity disorder sample essay.
References
Carabez, R., & Scott, M. (2016). ‘Nurses don’t deal with these issues’: nurses’ role in advance care planning for lesbian, gay, bisexual and transgender patients. Journal Of Clinical Nursing, 25(23/24), 3707-3715. doi:10.1111/jocn.13336
Chapman, R., Watkins, R., Zappia, T., Nicol, P., & Shields, L. (2012). Nursing and medical students’ attitude, knowledge and beliefs regarding lesbian, gay, bisexual and transgender parents seeking health care for their children. Journal Of Clinical Nursing, 21(7/8), 938-945. doi:10.1111/j.1365-2702.2011.03892.x Mental Health Case Study – gender identity disorder sample essay
Faught, D. D. (2016). Professional Issues. Coming Full Circle: The Old Becomes New Again — Cultural Competence and the Transgender Client. MEDSURG Nursing, 25(4), 285-286.
Levitt, N. (2015). Clinical Nursing Care for Transgender Patients With Cancer. Clinical Journal Of Oncology Nursing, 19(3), 362-367. doi:10.1188/15.CJON.362-366
Lim, F. A., & Bernstein, I. (2012). Promoting Awareness Of LGBT Issues In Aging in a Baccalaureate Nursing Program. Nursing Education Perspectives (National League For Nursing), 33(3), 170-175. doi:10.5480/1536-5026-33.3.170
Margolies, L. (2014). The Psychosocial Needs of Lesbian, Gay, Bisexual, or Transgender Patients With Cancer. Clinical Journal Of Oncology Nursing, 18(4), 462-464. doi:10.1188/14.CJON.462-464
Roller, C. G., Sedlak, C., & Draucker, C. B. (2015). Navigating the System: How Transgender Individuals Engage in Health Care Services. Journal Of Nursing Scholarship, 47(5), 417-424. doi:10.1111/jnu.12160

Case Study (15%)

The case study provides you with an opportunity to directly apply your knowledge learned this semester to case study. Please choose one of the two following case studies and analyze it directly according to the questions posted:
Feel free to use a first person perspective where you link ideas of yourself within your paper (i.e., the reason you chose your topic).
The paper should be no longer than 3 1/2 pages in length double spaced. Please note this means you must be succinct and thorough. Do not write in point form but use the usual paragraphs and sentences for this assignment.
Pages beyond the 3/12-page content limit will not be marked.
The page count will not include the cover page and reference list.
It is strongly recommended that you use headings as per the rubric and address the content required carefully.
3 current scholarly peer- reviewed articles should be incorporated in this paper. Government or professional organization resources will be considered “extra” references.
*Please note this essay must be written using strong APA format (i.e., title page, body of your paper and reference section). As mentioned, you can use a first person perspective when required in your writing for this course.
Enclosed you will find the headings expected for each case study. Remember that all you have to do is one case study. Ensure you follow the marking scheme beside the question in the syllabus. This will help you guage how many points you need per question.
Please ensure you review the syllabus carefully before addressing each question.
Case Study-Paulee
Please use these headings if addressing this case study:

Response
Form(s)
Conditions/Concerns
Nursing Care

Case study-Jorden
Please use the following headings if addressing this case study:

Questions
Concerns
Form(s)
Worries
Hallucination Interventions

Case Study One – Paulee

You are a nurse who is employed in a large city assertive community health outreach team. You have been assigned a 25 year old woman named Paulee. She lives with her partner in an apartment she rents using her disability support.
You have been asked to see this woman as she has been admitted to the hospital 5 times in the past year. The reason for admission has been self-inflicted injuries to her wrist and inner thigh region.
Upon meeting her at her home she says “I just can’t work or get it together.” She admits to feeling depressed and is having significant problems with her partner. She says “we are always fighting and things keep changing in our relationship.”
On your second visit to see Paulee she admits to you that she believes she “has always been transgender and that she cuts to relieve the stress she feels from her ongoing suicidal thoughts.” She said to you one day “I don’t care if I die. Even this stupid cutting that I am doing is not helping me anymore. Nothing helps..not the pills they give me or the booze I drink even touches my pain.”
One day you are in your office and you get a call from her partner Semara who says to you “I know you have been coming to see her as her nurse. I can’t take it anymore. I come home and find blood all over the bathroom from her constant cutting. She has been throwing things at me and is again threatening suicide. She is not eating anymore and keeps saying she will never fit -in and that our relationship is doomed because she wants to be a man.”  Semara continues saying “Paulee refuses to go to the hospital and I am afraid to leave her alone. I think she needs another admission. I don’t know what to do? How can I get to her to the emergency department on my own?
Questions

How would you respond to Semara in trying to help her be assessed by a professional given what sounds like an emergency situation? (3 marks)
What form(s) would she be admitted into the hospital under and why? (3 marks)
What type of condition(s) do you think that Paulee has and what are your concerns? (3 marks)
What type of nursing care would you try to provide for Paulee if she was admitted to your unit? Think about the priorities of care as well as on-going care within the unit (6 marks)

Case Study Two – Jorden
You are a nurse working evenings in the emergency department of an urban hospital. A 19 year of male patient named Jorden comes into your agency accompanied by his parents.
In relaying the reason for bringing Jorden into your setting his parent’s say “we don’t know what is wrong with him but we are starting to get worried. For a few weeks now we notice he is not speaking and is over eating. He used to be a very outgoing boy but we find that he is much more sullen and at times appears to be off in space day dreaming.”
They tell you that he was a star athlete on his hockey team up until he got into a fight during a game and hit his head a few months ago. They say he was admitted at your hospital with a fairly major concussion. Since then he has stopped playing hockey and just wants to watch T.V. holed up in his room and smoke pot. He has been eating more but refusing to go out with friends saying “they freak him out and that they are out to get him.” They say we have tried to reason with him but he is insistent he is being followed.
Since the incident he has not returned to school and interacts minimally with the family. They said the only time he goes out of the house is to get his marijuana and come home.
The parents say their family doctor has been worried about him and started him on a low dose of an antidepressant.  The parents say “enough is enough, he won’t shower and is eating us out of house and home and there is something wrong with how he is thinking—it is like he is paranoid about everything. He is just not the same kid we knew. He needs some help? Mental Health Case Study – gender identity disorder sample essay
When you meet Jorden you notice he is disheveled. He cannot maintain eye contact and does appear preoccupied in thought. He is mute and is refusing to speak. You sense that he is angry that his parents brought him to the hospital and that he has no insight into why he is here. In observing him you notice he turns his head to the side and whispers. In between times you are trying to engage him he returns to listening to his ear phones on full volume.
Questions

Upon admission, what type of questions would you ask of Jorden?  How would you address his preoccupation? Try to think of ways you could approach him to elicit answers?  (3)
What type of concerns would you have for this young man in terms of diagnosis (s) and why? (3)
If admitted to the hospital what form(s) would he be admitted under and why? (3)
What worries do you have in terms of his marijuana use and why? (3 marks)
How would you plan to interact with someone who has paranoia and may be experiencing hallucinations? (3). Mental Health Case Study – gender identity disorder sample essay

Appendix A

Promoting Healthy Aging: The Role of the Nurse

Topic: ELDERLY ABUSE

Research Question in PICO format:
DOES PATIENT EDUCATION, COMPARED TO NURSING EDUCATION PREVENTS ABUSE AMONG OLDER ADULTS.
P (Population/Patient) = Older adults, I (Intervention) = Patient Education, C (Comparative) = Nursing Education, O (Outcome) = Prevention of abuse (or even reduction)

Note: Education here may or may not necessarily means degree or schooling. It also involves, learning, awareness, enlightenment, knowledge, counselling, guidance, literacy etc. Mental Health Case Study – gender identity disorder sample essay

Purpose:
This paper allows students to explore a contemporary issue that affects the healthy aging of older Canadian adults.  Students will analyze their chosen issue within the context of healthy aging.

Marking and Paper Format Scheme
Marks

Introduction, Purpose and Background
·         Clearly define and describe the issue. Explain why this issue is important to: (a) the health of Canadian older adults; and (b) nursing practice (10 marks).
·         Clearly state your purpose or researchable question (5 marks). Mental Health Case Study – gender identity disorder sample essay

15

Strategies to Promote/Protect Health
·         Clearly and concisely describe your literature search strategy and the results of your search (5 marks).
·         Report three evidence-based interventions (2012 – 2017) from research articles that address your chosen issue. For each intervention (10 marks), report the following:
1.    Major findings: Describe the intervention in detail.
2.Relevance: How is the intervention relevant to your topic?
3.Usefulness: Are there any limitations (research or practical) to its usefulness for your selected topic?
4.    Reliability of data: Do the authors convince you that the evidence regarding this intervention is reliable? Why or why not?
5.    Credibility: Is the resource credible? Explain. Mental Health Case Study – gender identity disorder sample essay

35

The Nurse’s Role in Health Promotion/ Protection
·         What is the role of the nurse when addressing this issue in healthy aging? Consider:
1.the CNA (2015) Framework for the Practice of Registered Nurses in Canada (5 marks)
2.the holistic needs of older adults (physical, psychological, social, cultural, spiritual) (5 marks).
·         What are potential barriers/challenges for the nurse to consider when he/she is implementing the interventions (5 marks), and how might they be overcome? (5 marks)

20

Summary and Conclusions
·         Briefly summarize the purpose and main findings, and offer conclusions.

5

Writing Process
·         APA format (6th edition APA, second printing)
·         Scholarly Writing (spelling, grammar, organization, flow, depth of discussion)
·         Peer feedback form completed and submitted (signed by author and reviewer). Written paragraph that clearly summarizes the areas upon which you focused to improve your paper (refer to marker feedback provided in 63-171) Mental Health Case Study – gender identity disorder sample essay

10
10

5

Total
/100

Students must submit their own papers.
Important Information:

Page length is four double-spaced pages. Use APA 6th edition, second printing for format and writing style. Pages beyond four will not be marked nor read. The page limit does not include the title page, reference list, or appendix.

A minimum of three peer-reviewed articles, from scholarly sources will be used to support evidence based strategies and interventions. In addition, textbooks and other scholarly sources may be used to support your analyses. These articles must also be submitted with your paper, or your paper will be deemed late until they are submitted. Mental Health Case Study – gender identity disorder sample essay

All papers must be submitted to a plagiarism detection software for assessment. The originality report, with written explanation of similarity, must be submitted. Refer to course outline for detailed policies.

The paper must be submitted in a plain envelope, with your student number marked on the outside, otherwise the paper will not be accepted by the instructor.

Electronic paper submission is not permitted.

See the marking scheme and rubric for further detailed grading criteria

Writing style deductions will apply to papers. One mark will be deducted for every new spelling, grammar and sentence structure error, up to a maximum of 10 marks. Mental Health Case Study – gender identity disorder sample essay

Rubric for Grading Written Assignments

Category
Superior
Very Good
Average
Failing grade

Response to the Assignment
Applicable, plausible
Sophisticated insight into the concept of health within current and future trends. Many new ideas expressed.
Describes new concepts accurately.
Some insight and originality demonstrated.

Uses familiar concepts, offers few new concepts. Response to the assignment is adequate.
Lack of comprehensive thought or structure. Does not meet criteria for assignment.

Use of Evidence

Logical reasoning and support for statements.

Examples of primary sources evident. Critiques, analyzes, generates unanswered questions. Excellent integration of cited material into paper.
Mental Health Case Study – gender identity disorder sample essay

Examples of primary sources present.
Citations well integrated.
Some examples from the literature used to support points.
Quotes not well integrated.

No evidence of support from the literature referred to.
Quotes “plopped into the paper” Not integrated into sentences in a meaningful way.

Degree of Analysis

Analysis is fresh and exciting, poses new ways to view material and concepts.
Evidence related although points may not be clear.
Analysis offers nothing new, quotes do not relate to analysis
No attempt to link evidence to argument.

Application to Practice
Clear and definitive implications to self development are evident.
Application to self described: fair degree of breadth / depth of argument.
Surface level degree of application.
No application to self demonstrated or inappropriate application.

Professional Writing
Excellence throughout and is creative and original in thought. Excellent flow of logic and reason.
Free of grammatical errors and APA errors, presents ideas clearly and professionally. Mental Health Case Study – gender identity disorder sample essay
Presents ideas clearly and professionally. Good flow of logic and reason.
Free of grammatical errors and APA errors.
Presents ideas adequately with some laps in logic and reason.
Some grammatical or APA errors.
Writing clarity and flow is poor. No logical follow through of ideas.
Many grammatical and APA errors.

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Health Issues and Advocacy Assignment Sample Essay – Sweetened Beverages

Health Issues and Advocacy Assignment Sample Essay – Sweetened Beverages
Health Issue and Advocacy Assignment
The purpose of this assignment is to identify a health issue requiring advocacy from the nursing
profession on a local, regional, state, national, or international level. This topic can be related to
health promotion, population health, disease management, or patient safety in the community or
other healthcare setting. You are assuming the role of advocate in various capacities. The topic
you select for this paper will be the subject of your Policy Brief and Advocacy Letter
Assignment. Therefore, research thoroughly your topic of interest to ensure that it can be applied
across both assignments. Health Issues and Advocacy Assignment Sample Essay – Sweetened Beverages.
In this paper you will identify a health issue which may or may not already be represented in the
form of legislation or health policy. Individuals may just take a position on an issue affecting
local policy with decision makers.
ORDER A PLAGIARISM-FREE PAPER HERE
An example of this with legislation includes:
• Health issue: primary care access for patients
• Health policy: increasing primary care providers using nurse practitioners; support of PA
HB 765 for CRNP independent practice
An example of this without legislation includes:
• Health issue: increased chronic back pain from integration of technology in healthcare
• Health policy: ergonomic evaluation of work environments for all employees; letter of
support to employers for new healthcare organization policy
This assignment is worth 25% of your grade. Using APA format and criteria from the Grading
Rubric for Written Assignments, in 5 double spaced pages (excluding the title page and reference
page) present the following details:
Criteria for Your Advocacy as a Nursing Professional
Introduction
Outline of health issue and existing or necessary health policy
and/or politics. Why is this significant to nursing?
List and discuss any other stake holders who would be concerned
with the health issue, in favor or opposition.
Propose a plan on this health issue advocacy:
• Effect of the health issue on health policy and politics
• Interventions to be implemented in this advocacy to enact
change; incorporate health politics as pertinent
• Identify opposition which can be encountered.
Conclusion
Sweetened Beverages: The Health Issue
There is growing concern for the overall health of the United States.  Despite advances in medicine and the increasing amount of money expended on healthcare in the United States, chronic diseases are prevalent.  Not only do chronic diseases result in preventable premature death and reduce the quality of life of those who experience them, they place an economic burden on our healthcare system (Centers for Disease Control and Prevention, 2009).  According to the Centers for Disease Control and Prevention, (2009) 75% of health care costs are spent treating chronic and most frequently preventable conditions.  The incidence of chronic diseases are proportionally higher amongst minority groups. Health Issues and Advocacy Assignment Sample Essay – Sweetened Beverages
Excessive consumption of sweetened beverages is linked with obesity, diabetes, hypertriglyceridemia, cardiovascular diseases, amongst others (Centers for Disease Control and Prevention, 2010).  Diabetes is linked to many other health complications including kidney failure, amputations, and blindness (Centers for Disease Control and Prevention, 2009).  Excessive consumptions of sweetened beverages is also proportionally higher amongst certain demographic and ethnic groups including adolescents, non-Hispanic blacks, Mexican-Americans, those of low socioeconomic status, and those who are obese.  It is estimated that amongst these groups up to 16% of daily total caloric income is from sweetened beverages (Centers for Disease Control and Prevention, 2010).
Prevention of chronic and preventable disease, such as those mentioned above, has been the focus of attention for the healthcare community and our policy makers in an effort to make our healthcare system more affordable and increase the quality of life of Americans.
Public Policy to Address Issue
On June 16, 2016 the City of Philadelphia passed the, “Sugar-Sweetened Beverage Tax,” which amended Title 19 of the Philadelphia Code, Finance, Taxes and Collections (City of Philadelphia, 2016).  Philadelphia has modeled its new policy on other cities and countries that have enacting similar policy measures aimed at improving the health of the country including; Arkansas, Tennessee, Virginia, and West Virginia (Drenkard, S., 2011).  This policy attaches and additional one and one-half cent per fluid ounce tax to be paid to the city of Philadelphia for the purchase of all beverages sweetened with the following ingredients: sucrose, glucose, or high fructose corn syrup.  Health Issues and Advocacy Assignment Sample Essay – Sweetened Beverages  The tax also includes sugar substitutes including: stevia, aspartame, sucralose, neotame, Ace-K, saccharin, and advantame (The City of Philadelphia, 2016).  This includes non-alcoholic syrups that contain any of the above sweeteners.  Excluded from this tax are baby formula, “medical food,” products that are more than 50% milk, juices that are more than 50% fresh fruit or vegetable juice (The City of Philadelphia, 2016).
The Effect of Consumption of Sweetened Beverages on Politics and Policy
Based on the above public health concerns including the overwhelming stress chronic disease places on the healthcare systems, policy makers are exploring methods of reducing the public’s consumption of products that are correlated with chronic disease and obesity when consumed regularly through taxation.  These taxes are likened to sin taxes placed on items such as alcohol and tobacco products (Letcher, Frisvold, & Tefft, 2011).
Contrary to other sales tax whose profits are considered general revenue for the city and state, the City of Philadelphia and Mayor Kenny, a supporter of the policy, pledge to use the revenue to support publically funded universal pre-kindergarten programs (Kennedy, 2016).  In fact Mayor Jim Kenney was quoted The Christian Science Monitor (2016, para. 4) as attributing the successful passing of the legislation to his plans for the revenue, “if you want to tax something and people know where the money’s going to, then it’s easier for them to get behind it.”  Interestingly the use of the revenue for the tax does not appear in the body of the legislation.
Opposition to Plan
There are numerous critiques of such legislation.  Developing policy aimed to reduce rates of obesity is difficult to measure.  Research connecting improved health outcomes associated with the excise tax seems controversial.  Research generated from places that already introduced the tax has not yet been able to establish a connection between reduced sweetened beverage purchases and improved health outcomes (Shekhtman, 2016; Fletcher et al., 2011; & Colchero, Popkin, Rivera, & Wen Ng, 2016).  Berkeley, California passed a similar policy in 2014, however it has not yet been established that this has reduced obesity rates (Shekhtman, 2016).
Cabera Escobar, Veerman, Tollman, Bertram, & Hofman (2013) in their meta-analysis found only 6 articles based on research conducted in the United States that supported a possible connection between decreased purchasing of Sugar-Sweetened Beverages and a reduction in BMI.  However, none of these studies were not able to establish a statistically significant reduction in BMI when rates of purchasing sweetened beverages fell (Cabera Escobar et al., 2013).   Fletcher et al., (2011) examined current obesity trends in the United States and compared that data to areas of the country that have enacted such taxes.  Their research revealed a positive correlation between obesity rates and a sweetened beverage tax, however, the reduction in obesity rates were only minimal. Health Issues and Advocacy Assignment Sample Essay – Sweetened Beverages,
Research has also been done to examine the impact of similar taxation in Mexico.  This is distinguished from the Philadelphia legislation in that it is a federal tax.  Mexico, too, was interested in creating a tax in effort to reduce consumption of sugary beverages and its associated health problems.  Mexico not only has high rates of overweigh and obese individuals; 33% in the 2-18 age group and 70% in the over 18 age-group.  Between 2000 and 2006 rates of obesity increased another 12% throughout the country (Colchero et al., 2016).  Mexico also rendered the highest consumption of soft drinks by 2011. Colchero et al. (2016) compared consumption in 2012 and again in 2014.  By December of 2014 the average monthly purchase for sugary beverages decreased by 12%.  The tax in Mexico resulted in an approximate 10% increase in price for sugary beverages.  The Mexican government invested the revenue to programs that decreased health disparities in their country, which may potentially service to expand the impact of the program on the overall health of the Mexican population (Colchero et al., 2016).  This study also has limited impact, as it does not make a correlation in the reduction of the purchase of sugary beverages to improved health outcomes Health Issues and Advocacy Assignment Sample Essay – Sweetened Beverages.
Opponents also argue that the tax is regressive, meaning it will affect the lower income individuals and families more heavily that it will affect the affluent population. This is due to the fact that a larger portion of their income is spent on food products. While this may be true, it is also important to note that because Sugar-Sweetened beverages are not necessary to sustain life.  Proponents also argue that because obesity and diabetes affect the lower income in greater proportions that population will benefit the most (Wang, n.d.).
Interventions
The introduction of the excise tax on Sugar-Sweetened Beverages is an effort of the government to discourage the excessive consumption of sweetened beverages such as soft drinks.  Proponents believe this change in eating behavior will cause individuals to have improved health and in turn reduce healthcare costs.  According to several studies research has demonstrated sugar-sweetened beverages are price elastic, meaning that as prices raise consumption will decline in similar proportion (American Health Association, 2016; Escobar, Veerman, Tollman, Bertram, Huffman, 2013; & Wang, n.d.)
In their research, The Centers for Disease Control and Prevention (2010) found that in order to modify obesity rates and improve the overall health of a population, more action must be taken.  Not only should a form of discouragement be placed to deter individuals from purchasing sugary beverages, access to safe and flavorful drinking water must be ensured, access to and consumption of alternatives must be promoted and encouraged, there must be a decrease in cost of healthier alternative beverages, marketing for sweetened beverages must be minimized particularly for children, screen and counseling about the dangers of sweetened beverages must be provided, and medical providers must have increased training regarding how to educate their patients on the dangers of sweetened beverages. Health Issues and Advocacy Assignment Sample Essay – Sweetened Beverages.
Several sources identify the excise tax is only one step necessary to address the current health care crisis from conditions such as obesity, diabetes, and heart disease (Centers for Disease Control and Prevention, 2010 & American Public Health Association, 2016).  While the legislation has not yet gone into effect in Philadelphia, there has been little discussion regarding increasing prevention efforts and making healthier options more available and affordable for low-income consumers.  It is also concerning that Philadelphia has not included prevention efforts in its use for the revenue.
Conclusion
While most healthcare professionals, including nurses, will agree that excessive consumption of sweetened beverages contributes to health problems, it is questionable if imposing an increase in tax on those items alone will produce the intended effect of improved health. Health Issues and Advocacy Assignment Sample Essay – Sweetened Beverages While some research has linked an increase in taxes to a reduction in the consumption of those items, similarly to taxes imposed on tobacco and alcohol products, research has not yet established that this reduction in consumption of sweetened beverages leads to improved health outcomes.  It seems that without meaningful intervention to both motivate the American Consumer to engage in healthier behaviors and without increasing access to healthier products across all socioeconomic backgrounds, the effect of a sweetened beverage tax will not produce the marked improvement in health it promises.

References
American Public Health Association. (2016). Taxes on Sugar-Sweetened Beverages.  Retrieved from https://www.apha.org/policies-and-advocacy/public-health-policy
Cabera Escobar, M.A., Veerman, L.J., Tollman, S.M., Bertram, M.Y., & Hofman, K. (2013).  Evidence that a tax on sugar sweetened beverages reduces the obesity rate: a meta-analysis.  BMC public health, 13 :1072.  doi: 10.1186/1471-2458-13-1072
Centers for Disease Control and Prevention. (2010) The CDC Guide to Strategies for Reducing the Consumption of Sugar-Sweetened Beverages.  Retrieved from http://www.cdph.ca.gov/SiteCollectionDocuments/StratstoReduce_Sugar_Sweetened_Bevs.pdf
Centers for Disease Control and Prevention: National Center for Chronic Disease Prevention and Health Promotion. (2009). The power of prevention: chronic disease…the public health challenge of the 21st century.  Retrieved from http://www.cdc.gov/chronicdisease/pdf/2009-power-of-prevention.pdf
City of Philadelphia. (2016). Sugar-Sweetened Beverage Tax.  Retrieved from https://phila.legistar.com/LegislationDetail.aspx?ID=2595907&GUID=36060B21-D7EE-4D50-93E7-8D2109D47ED1&Options=ID%3C/p%3E%3Cp%3EText%3C/p%3E%3Cp%3E&Search=160176
Colchero, M.A., Popkin, B.M., Rivera, J.A, Wen Ng, S. (2016). Beverage purchases from stores in Mexico under the excise tax on sugar sweetened beverages: observational study BMJ 2016; 352 :h6704 Retrieved from http://www.bmj.com/content/352/bmj.h6704
Fletcher, J.M., Frisvold, D., & Tefft, N. (2010).  Can soft drink taxes reduce population weight.  Contemp Econ Policy; 28(1): 23–35. doi:10.1111/j.1465-7287.2009.00182.x.
Kennedy, M. (2016, June 16).  Philadelphia Becomes the 1st Major U.S. City to Pass a Tax on Soda.  The two-way: Breaking news from NPR.  Retrieved from http://www.npr.org/sections/thetwo-way/2016/06/16/482359140/philadelphia-becomes-1st-major-u-s-city-to-pass-a-tax-on-soda
Novak, N.N. & Brownell, K.D.  (2012). Role of Policy and Government in the Obesity Epidemic.
Circulation;126:2345-2352. http://dx.doi.org/10.1161/CIRCULATIONAHA.111.037929
Shekhtman, L. (2016, June 17). How Philadelphia Passed a Soda Tax.  The Christian Science Monitor.  Retrieved from http://m.csmonitor.com/Business/2016/0617/How-Philadelphia-passed-a-soda-tax
Wang, Y.C. (n.d.).  The Potential Impact of Sugar-Sweetened Beverage Taxes in New York State: A Report to the NYC Department of Health & Mental Hygiene.  Columbia University. New York, NY: Author. Health Issues and Advocacy Assignment Sample Essay – Sweetened Beverages

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