Week One Discussion NR601

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School

Chamberlain University College of Nursing *

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601

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Medicine

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Apr 3, 2024

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docx

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Week One Discussion NR601 Good evening Professor and Class, I live in Allegheny County, Pennsylvania which has a total population of 1,250,578 and the median income is $72,031. This is comparable to the rest of the state which has a median income of $71,798. The percentage of the population living in poverty is 11.4% which is slightly lower than the state percentage of 11.8%. The percentage of people living without health insurance is 3.6%. This is a decent amount lower than the state percentage of 5.3%. In Allegheny County 44.8 percent of individuals hold a bachelor's degree or higher, this is significantly higher than the percentage for the rest of the state which is only at 35.1%. The highest life expectancy for Allegheny County was 86.0 years of age and the lowest life expectancy was 66.7 years of age. In comparison the average life expectancy for the state is 78.6 years of age. As stated in the video geographic location is one of the factors affecting life expectancy the most, I think that specific to my county a demographic that heavily affects life expectancy is race. Specifically, African American individuals who statistically have the lowest life expectancy out of all racial/ethnic groups. According to some studies this could suggest that black individuals have a lower rate of security which affects the decisions that they make throughout their life. (De Ramos et al, 2022) Health systems can mimic the systemic racism present in society even unintentionally. This can be through treatments inappropriate for racial preferences, poor allocation of resources to disadvantaged areas, and failure to consider a patient’s financial barriers to care. (Hone et al., 2022) In another study black individuals were 40% less likely then white individuals to receive recommended treatment for hypertension, this was especially the case when the black individuals were uninsured. (Boulware, 2022) Black individuals are less likely to have access to healthy food and affordable health care. One way that I plan to address these types of health disparities in my own practice beyond continuously challenging my own unconscious bias, is to ensure that I am well acquainted with local resources. As a nurse who has worked closely with the disadvantaged in the community it can be invaluable to an individual to be provided with resources that can help them address things such as food insecurity, transportation barriers, and things that may affect their ability to even pick up needed medication from the pharmacy. As an FNP it is my hope to be able to truly treat my entire patient in every sense of the word. Reference Boulware, L. E. (2022). Looking upstream–the role of primary care in addressing US race inequities in Kidney Health. Journal of the American Society of Nephrology , 33 (7), 1249– 1251. https://doi.org/10.1681/asn.2021101289 De Ramos IP, Auchincloss AH, Bilal U. Exploring inequalities in life expectancy and lifespan variation by race/ethnicity and urbanicity in the United States: 1990 to 2019. SSM Popul Health. 2022 Sep 13;19:101230. doi: 10.1016/j.ssmph.2022.101230. PMID: 36148325; PMCID: PMC9485214. Hone, T., Gomez, S., Rao, M., Ferreira, A., Barkley, S., & Swift Koller, T. (2022). Primary health care as a platform for addressing racial discrimination to “Leave no one behind” and

reduce health inequities. International Journal for Equity in Health , 21 (1). https://doi.org/10.1186/s12939-022-01779-1 Rikki Buccieri YesterdayNov 4 at 10:22am Manage Discussion Entry Hi Terri, Thank you for sharing your county information. I live less than 1 mile over the Allegheny Butler county line. I can not believe when you look at the statistics how different they can be from one county to another so close together. Surprisingly, as you mention the majority of the individuals who make up the poverty are African Americans in Allegheny County, but in Butler County the individuals who encompass the greatest level of poverty are white females ages 18-24 and then followed by white males 55-64. It is such a drastic change. Their income is below standards and housing is difficult to obtain which is why most of it is government housing ( DataUSA,n/d). In my opinion, this is due to a lack of education and the high drug rates we have as a community. We see this as medical professionals with the amount of drug overdoses. I agree with you that intervening with earlier education in school would benefit lifelong health education and decrease early mortality. In areas where there are documented health disparities such as difficulty with children having checkups, school nurses should be required to regularly check in until graduation. Providing required screening, education, and teachings(Harari & Lee, 2021). Also, the statistics show these individuals have health care coverage or are at least reporting it so we as providers need to assist to not only treat but also help provide resources where they can find additional help. DataUSA. (n/d). Butler County . Retrieved from Butler County, PA | Data USA Links to an external site. Harari, L. & Lee, C. (2021). Intersectionality in quantitative health disparities research: A systematic review of challenges and limitations in empirical studies, Social Science & Medicine, Social Science & Medicine, 277.https://doi.org/10.1016/j.socscimed.2021.113876 Rikki, Thank you so much for your reply! It is very interesting that there is such a difference between two neighboring counties. Looking at the

data for the two counties I can only surmise that the difference is due to the primary race composition for the two counties. In Allegheny county the population is 12.5 % black/African American compared to the 0.95% in Butler county. However this is an excellent example of how preventative health services must be tailored to specific patient populations. Each provider must know their own community in order to best serve their patients. Bednarczyk, R. A., Chamberlain, A., Mathewson, K., Salmon, D. A., & Omer, S. B. (2018). Practice-, Provider-, and Patient-level interventions to improve preventive care: Development of the P3 Model. Preventive medicine reports , 11 , 131–138. https://doi.org/10.1016/j.pmedr.2018.06.009 DataUSA. (n/d). Allegheny County . Retrieved from Allegheny County, PA | Data USA

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Week One Discussion NR601

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