NUR 703 Discussion 4.1: Public Health Planning and Vulnerable Populations

NUR 703 Discussion 4.1: Public Health Planning and Vulnerable Populations

NUR 703 Discussion 4.1: Public Health Planning and Vulnerable Populations

• The characteristics (age, sex, race, ethnicity, geographical location, etc.) of the vulnerable population including prevalence. 

The article that I found discusses the rise of syphilis in the United States in the past few years. It focuses on the Fresno California Health Department employees go out into the community to locate individuals who have tested previously for the disease or at higher risk of contracting it. In this article the population is poor and living in a homeless community or low socioeconomic area. Those at most risk are African-Americans, Hispanic and Native Americans babies born with congenital syphilis. High risk populations include those who are pregnant, immunocompromised individuals and undergoing some sort of treatment, men who have sex with men, and those who have HIV and are sexually active (CDC, 2021). The article sites the CDC stating that in 2019 there were almost 130,000 cases reported which was double that of cases reported five years before. Congenital cases for babies quadrupled, 1,870 were born with syphilis and 128 died from it.  The count for 2020 cases is still being calculated however the CDC states it will most likely be higher than last year (Chen, 2021).  According to CDC statistics, women across the United States make up about 16.7% of cases; men about 18.7%; homosexual men are about 41.6%; bisexual men make up 5.5%; and men with unknown sex of sex partners are 17.3%. There is no one age that is affected by syphilis (CDC, 2021). Once infected it can be treated by three doses of PCN. However, if not treated or treatment is not completed the disease will still lay dormant in the body and emerge later causing many problems and possibly death for unborn children.

               Rise of syphilis in the U.S reflects neglect of long-term public health funding : Shots – Health News : NPR (Links to an external site.)

The impact of the vulnerability on health

      Vulnerability affects health simply by not having adequate access or education surrounding health care. Following up with a PCP for regular health checkups immediately puts individuals at risk for increased health issues due to lack of testing, diagnostics, education, prevention, health insurance, transportation, lack of solid nutrition and risky behaviors leading to other complications. For many, not understanding or being aware of the dangers of illnesses and later consequences from them or impact upon children poses a threat to continue in behaviors that perpetuate the illnesses.  Many might be embarrassed or feel shame for certain actions that got them into a particular situation so this only drives them further away from seeking help.  Many cannot or do not follow up with other appointments so noncompliance is a huge factor to prolonging a disease process. The article talked about County Health Department employees going into the vulnerable communities to check in with people and encourage follow ups or initial health care and attempting to get them to the facilities for care making sure to let them know they are not in trouble (NPR, 2021). Formulation of a plan or community health goal is necessary to improve at risk populations in their health and well-being.

• In a primary health care role, briefly describe a prevention intervention (primary, secondary, or tertiary) to address the health issue for the vulnerable group.
  • Depending on your article, how would you plan your prevention intervention differently if the health need were in a rural community (or urban community)? 

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      In reading this article and knowing this is only one town or county in America that is seeing a rise in syphilis, many other towns too

are also having a rise in this once almost eradicated disease.  It is important to be able to provide education and testing for those at risk and be able to follow up with them to receive more treatment if necessary, prenatal care if pregnant, safe sex information, and what the signs and symptoms of this illness are and how it affects people along with the unborn. Community intervention I feel would be the first choice and also providing a mobile health care unit to go to the different areas in poorer areas that do not have transportation or are reluctant to seek out care, and also provide the homeless communities with access to health services.  first choice would be prevention across the board however knowing that this illness is on the rise, I think following up with continued treatment or initiation of treatment would be the next major task to institute to make sure people are receiving the care they need and following up to complete treatment.  The article talks about this difficulty in securing treatment for the vulnerable due to a variety of issues, and case loads are huge with time being scare. I’m not really sure I would do something different from what many health departments are attempting to do except I think a mobile unit would benefit communities greatly.  My hope is that there can be a way to figure this all out to allow for access to appropriate health care for those at risk to increase their health.

References

Centers for Disease Control (2021), National Overview  Sexually Transmitted Disease Surveillance 2019. Retrieved from www,cdc.gov/std/statistics/2019/overview.htm#Syphillis  on November 1, 2021

Chen, C. (2021). Syphilis is Resurging in the US; a Sign of Public Health’s Funding Crisis. Retrieved from www.npr.org/sections/ (Links to an external site.) health-shots/2021/11/1/1050568646/syphilis-std-public-health-funding on November 1, 2021

Immunization Coverage

This article has been published by the World Health Organization regarding a general overview of hepatitis.  “Hepatitis is an inflammation of the liver that is caused by a variety of infectious viruses and noninfectious agents leading to a range of health problems, some of which can be fatal” (WHO).  With the pandemic posing a threat to scheduled vaccinations, there has been “an estimated 23 million children under the age of one year did not receive basic vaccines, which is the highest number since 2009” (Immunization coverage, 2021).  While studying public health, one of the ways public health nurses care for the communities they live in is through the use of prevention.  Primary, secondary, tertiary prevention all play a major role in preventing outbreaks.  There are millions of people who do not have appropriate access to general medicine therefore they do not have access to vaccinations.

As we have seen through throughout the years using vaccinations, we are able to diminish and practically eradicate preventable communicable diseases.  Though due to covid 19, there began a mixture of fear and anxiety that steered people away from healthcare facilities.  Which leads to millions of people not being vaccinated against preventable diseases.  Though not just in developed countries is there an issue with millions of people not being vaccinated appropriately though the numbers are able to be more accurately proposed.  In developing countries, there have always been issues with vaccinating appropriately as well as access to good healthcare in general. According to WHO, “in 2020, 17.1 million infants did not receive an initial dose of DTP vaccine pointing to lack of access to an immunization and other health services and an additional 5.6 million are partially vaccinated” (Immunization coverage, 2021).

For those children that are not vaccinated appropriately and do not have access to healthcare, they are more susceptible to disease and death from preventable diseases, whether they are communicable or not.  Not only are vaccines a method for prevention; the access to healthcare itself allows for the prevention of many diseases.  In a primary healthcare role, primary prevention such as vaccine clinics will allow for the most adequate prevention in vulnerable groups.  This does not only benefit those in developing countries but also those who are located here in America.  Because there have been many refugees and immigrants that have come to look for better lives with better access to healthcare, though they don’t always receive it due to outrageous costs or literal no access due to their location.

My plan regarding immunization coverage would involve a vaccination clinic with consequent primary care visits, kind of like the concept/ group Doctors without Borders, except this group of individuals works in the USA to provide care to those in need in our own country.  I would like the same format as providing emergency medical care to those in need, since those populations have limited/ no access to resources this would provide a condensed version of medical care.  Though this is not a cure-all this allows for some medical care where there is none.

This concept I believe would work for both rural and urban areas, though for urban use we would need more staff to reach more people due to the density of people.  This not only includes going to areas that are heavily populated with homeless people like seen about Skid Row in LA.  This primary prevention strategy would allow for vaccinations as well as other primary preventing strategies such as blood pressure readings and glucose testing.  In order for a concept like this to work, it has to be proven to work, and also like everything we need to have money and access to resources ourselves to provide for those in need.

World Health Organization. (n.d.). Hepatitis. World Health Organization. Retrieved November

3, 2021, from https://www.who.int/health-topics/hepatitis#tab=tab_1

World Health Organization. (2021, July 15). Immunization coverage. World Health

Organization. Retrieved November 3, 2021, from https://www.who.int/news-room/fact-sheets/detail/immunization-coverage.

In the CNN article written by Fox, 2018, entitled“ South African researchers keep wary eye on yet another new coronavirus variant,” she describes the latest COVID variant called C.1.2 noticed in Africa, Asia, and the Pacific. Like the other variants Alpha, Beta, and Gamma, the new C.1.2 is infectious, but there are still questions about whether it is more contagious than the different strains. COVID  infects populations equally regardless of age, sex. ethnicity, or geographic location.  The significant impact on South Africa is how easily and dangerously it can  transmit to its over 500 million people. The impact of the vulnerability on the health of South Africans and the world cannot be understated. The impact of a new variant in  South Africa is concerning because of the number of people who visit the country. Tourism supports 10.3% of the country’s jobs and contributes ZAR 102 billion to the GDP so visitors could quickly take the new variant across the globe. Despite the wealth of the country social determinates such as poverty, infectious diseases, social inequities, high levels of alcohol use,  lack of nutritious food, housing  and access to clean water  still exist (Scott et al., 2017). The entire world becomes a vulnerable population to C1.2 since there is still no known cure.

The primary protection mechanisms of washing hands, wearing a mask, and maintaining social distance still apply to this new variant. The secondary measures of getting vaccinated, testing for Covid, and isolating infected people prevent transmission of the COVID virus. The development of tertiary prevention is still in the  experimental phase.  The prevention intervention is similar whether the area is in a rural or an urban community. Currently, prevention is still the best strategy for managing COVID.

References

Fox, M. (2021, August 31). South African researchers keep wary eye on yet another new coronavirus variant. CNN. https://www.cnn.com/2021/08/30/health/new-coronavirus-variant-maybe/index.html (Links to an external site.).

Scott, V., Schaay, N., Schneider, H., & Sanders, D. (2017). Addressing social determinants of health in South Africa: the journey continues. South African health review, 2017(1), 77- 87. https://hdl.handle.net/10520/EJC-c80ea0402 (Links to an external site.)