Disease Distribution and Management

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Solution

HE007: Disease Distribution and Management

Instructions

Write your responses where it reads “Enter your response here.” Write as much as needed to satisfy the requirements indicated. Each item contains the rubric which will be used to evaluate your responses.

Short Answer 1

You are a healthcare administrator in a hospital and are contributing to a community health needs assessment (CHNA) for your county. Visit http://www.cdc.gov/brfss/brfssprevalence/ , and complete the following:
Note: Detailed instructions for the use of this site, titled “Instructions for SMART: BRFSS City and County Data,” is available in the Assessment materials, if needed.

  1. From the pull-down menu, select the criteria for the desired health risk data, select MMSA: AL- Tuscaloosa, Year: 2012, and Category: Chronic Health Indicators.
  2. Click on the questions to view the prevalence of each chronic disease. For example, to view the prevalence rate of heart attacks among Tuscaloosa residents, click on “Ever told you had a heart attack (myocardial infarction)?” to discover that 3.6% of Tuscaloosa residents report ever having suffered from a heart attack.
  3. After viewing the data for each of the Chronic Health Indicators, scroll down and click on Overweight and Obesity (BMI) and then Weight Classification by Body Mass Index (BMI) to view obesity rates for Tuscaloosa.
  4. Now, compare the prevalence of each chronic disease in Tuscaloosa to the prevalence in Alabama.

Based on the information you analyzed, respond to the following prompts:

  • Identify 10 indicators to measure public health that you would use to develop a holistic picture of the health of the community in Tuscaloosa. Describe what each indicator measures, and justify its necessity for the CHNA. You should use a mix of socio-economic, disease, and clinical indicators. (2–3 sentences for each indicator)
  • Explain how three stakeholders should be involved to ensure the entire spectrum of community needs is considered. (1–2 pages)

Your Response

The following are the indicators IO would use to measure public health:

  1. Education: this is the most basic element as it shapes future occupational opportunities and earning potential. It also offers skills and knowledge, which allow better-educated people to readily access information and resources to promote healthcare. It is important for CHNA since collateral benefits like decreasing health care costs could also emerge from increased investment in education.
  2. Income: this measures the ability for an individual to purchase health care. Higher income offers better nutrition, schooling, housing, and recreation. Underinvestment in public goods and welfare and inequality experiences are greater in more stratified societies and this affect healthcare in the long run. The relationship between income health is stronger at lower incomes, income impacts persist above the level of poverty.
  3. Life expectancy at birth: this is the average number of years, which a newborn is expected to live if he/she was to pass through life exposed to the sex-and age-specific death rates that prevail at the time of birth. This will help CHNA to know the average years newborns would live, and thus offering insights when making healthcare policies, and during budgeting.
  4. The total fertility rate: this measures the average number of children a woman is expected to have when 50 years old. This are normally subject (throughout a woman’s life) to age-specific fertility rates recorded in a given year. It measures the number of children per woman. When CHNA has a knowledge of this, it will be able to approximately budget for the health of the communities.
  5. HIV prevalence rates: this measures the percentage of people who live with HIV. Prevalence is a measure of the frequency of existing infection in a specified population at a specific time. This indicator can be measured/ modelled using a spectrum software. This indicator directly impacts the health of a nation, consequently its productivity. With this in mind, CHNA can know the areas that are highly infected with the virus, and thus resources needed to curb its spread.
  6. Chronic disease indicators: these are set of surveillance indicators that are developed by consensus. They enable CHNA and health policymakers to retrieve uniformly defined state and selected metropolitan-level data for chronic diseases and risks factors, which have a substantial effect on public health. The indicators help in the surveillance, evaluation, and prioritization of public health interventions.
  7.  Disability rates: Disability Adjusted Life Years (DALY); this is an indicator that measures the number of years of healthy life lost due to all causes whether from premature mortality to disability. It helps CHNA to measure, and find the burden of infections in a specified population and efficiency of the interventions. The measurands used are; life table of the population, and loss of healthy life as a result of disability.
  8. Quality Adjusted Life Year (QALY); this is the measure of the cost efficiency of the interventions in health. It measures the number of years of life added by a successful treatment or adjustment for life quality.
  9. Indicators of social and mental health: these measures the rate of homicide, suicide, other crimes, road or traffic accidents, domestic violence, and substance abuse. They will help CHNA by providing a guide to social action for improving people’s health. The social and metal health of children are dependent on their parents.
  10. Environmental indicators: these are the measures of the quality of biological and physical environment where diseases occur and people reside. The most crucial ones are those that measure the proportion of population that have access to safe drinking water and sanitation facilities. They offer CHNA the explanation of the prevalence of communicable diseases in communities. Other indicators measure the pollution of water, air, noise pollution, and exposure to toxic substances to water and food.

Key stakeholders

  1. International organizations like WHO, ILO, and World Bank. They spearhead the creation of the access to sustainable and productive employment, improvement of health, development of health communities, equitable treatment of citizens and creation of fair and civil societies. They promote workplace as the main setting for health and encourage development at community level.
  2. National and local government: governments at all levels have responsibility for disease prevention and health protection at a societal and community level. Governments ensure that the policy framework where organizations operate entails workplace health promotion. They also create an environment that is proactive in promoting health and well-being and create opportunities for communities to participate in health promotion initiatives through national and community health campaigns.
  3. Employers: they normally require a fit and productive workforce if they are to remain competitive, viable and able to deliver services to communities. They should be totally involved in national/local programs and projects that are designed to promote employee and community health.

Rubric

 0 Not Present1 Needs Improvement2 Meets Expectations3 Exceeds Expectations
Sub-Competency 1: Analyze community health needs using public health and clinical data.
Learning Objective 1.1: Analyze indicators to measure public health.Analysis of indicators to measure public health is missing.Response analyzes fewer than 10 indicators to measure public health.   Indicators are not appropriate to measure public health.Response accurately and thoroughly analyzes 10 indicators to measure public health, and justifies its necessity for the CHNA.     Response represents a diverse mix of socio-economic, demographic, disease, and clinical indicators.Demonstrates the same level of achievement as “2,” plus the following:   Response includes a logical rationale on why each indicator was chosen.  
Learning Objective 1.2: Explain how stakeholders should be involved to ensure that community needs are considered.Explanation of which stakeholders should be consulted is missing.Response vaguely explains how stakeholders should be involved to ensure that the entire spectrum of the community needs is considered or includes fewer than three stakeholders.Response accurately and thoroughly explains how at least three logical stakeholders that should be involved to ensure that the entire spectrum of community needs is considered.Demonstrates the same level of achievement as “2,” plus the following:   Response explains how to engage the three stakeholders to get their input for the CHNA.

Short Answer 2

Visit the “CHNA Map Gallery” (https://engagementnetwork.org/assessment/) to respond to the following prompts.
Note: Detailed instructions for the use of this site, titled “Instructions for CHNA Map Gallery,” are available in the Assessment materials, if needed.

Each rectangle on the screen links to a map of a different indicator, grouped into demographic measures, social and economic factors, the physical environment, health behaviors, clinical care, and health outcomes categories. Hover over the rectangle to view each indicator or view the label listed directly below the rectangle.

  1. Click on a relevant map. In order to view data specific to the questions in this Assessment, type Santa Fe, NM into the box labeled “Enter a location” in the upper right-hand corner.
  2. Using the box labeled Map Layers on the right side of the screen, you can view the data in different ways. For example, click Label to view the numerical value for the indicator displayed on the map.
  3. Return to the Map Gallery tab to view a broad array of socio-demographic and health indicators.

Based on the information you analyzed, respond to the following prompts:

  • Describe Santa Fe, New Mexico using the following five gallery categories: demographic measures, social and economic factors, the physical environment, health behaviors, and clinical care. Select at least three indicators per category. (1–2 pages)
  • Using the health outcomes category, describe the prevalence of two infectious diseases and two chronic diseases in Santa Fe, New Mexico. (1 paragraph)

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Disease Distribution and Management
Disease Distribution and Management

Your Response

Demographics

The current population demographics and the changes in demographic composition over time play a significant role in the types of health and social services required by communities. a total of 148,917 people lives in 1,910.10 square mile report areas. The population density is estimated to be 77.96 persons per square mile. This is less than the national average population density of 91.42 persons per square mile.

  1. Population under age 18: the number of people under the age of 18 is important because this population has a unique health requirement that should be considered separately from other age groups. it is estimated that 18.81% of the population in Santa Fe is under 18 years. A total of 28,007 youths resides in Santa Fe during the period.
  2. Population age 18-64: this indicator shows the percentage of population age 18-64 in the designated geographical area. It is important since it is relevant to understand the percentage of adults in the community, since this population presents a unique health needs and should be handled separately from other age groups. the percentage population aged 18-64 is 59.19% in Santa Fe. This is lower than the percentage of New Mexico, which is 60.06%. About 59.91% of male population fall under the age group of 18-64, and 58.51% of the female population fall under the same group.
  3. Population age 65 and above: during this period, about 32,763 adults aged 65 and above lived in Santa Fe. This number is important since this population has got unique health needs that should be considered separately from other age groups. The percentage of population aged 65 and above is 22.00% in Santa Fe. This is higher than that of New Mexico, which is 16.32%, and that of the entire country, which falls at 15.25%.

Health behaviors

Health behaviors like poor diet, lack of exercising, and substance abuse contribute to poor health status.

  1. Alcohol consumption: this indicator gives the report of the percentage adults that are aged 18 and older that self-report heavy alcohol consumption. This indicator is important since current behaviors are determinants of future health and this indicator may show a cause of significant health issues, like cirrhosis, cancers, and untreated mental and behavioral health needs. The percentage of adults who are estimated to be drinking excessively in Santa Fe is 14.10% (age-adjusted).
  2. Alcohol expenditures: this indicator shows the estimated annual expenditures for alcoholic beverages purchased at home, as a percentage of the total household expenditures. This indicator is relevant because current behaviors are determinants of future health and this indicator may illustrate a cause of significant health issues, such as cirrhosis, cancers, and untreated mental and behavioral health needs. Expenditures data are suppressed for single counties and single-geography custom areas. Rank data are not available custom report areas or multi-county areas. The percentage of food-at-home expenditures of New Mexico is 14.12%.
  3. Physical inactivity: within Santa Fe, about 14,188 adults that are aged 20 and older self-report no leisure activity. This indicator is relevant because current behaviors are determinants of future health and this indicator may illustrate a cause of significant health issues, such as obesity and poor cardiovascular health. The percentage population with no leisure time physical activity is about 11.4% in Santa Fe.

Health outcomes

The measurement of morbidity and mortality rates allows assessing linkages between social determinants of health and outcomes. By comparing, for example, the prevalence of certain chronic diseases to indicators in other categories (e.g., poor diet and exercise) with outcomes (e.g., high rates of obesity and diabetes), various causal relationship may emerge, allowing a better understanding of how certain community health needs may be addressed.

  1. Asthma prevalence: this reports the percentage of adults that are aged 18 and older who self-report that they have ever been told by a doctor, nurse, or other health professional that they have asthma. The percentage of adults with Asthma in Santa Fe is 12.40%. This is lower than that of New Mexico that is 14.20%.
  2. Cancer incidences – all cases: This indicator reports the age adjusted incidence rate (cases per 100,000 population per year) of cancer (all sites) adjusted to 2000 U.S. standard population age groups (Under age 1, 1-4, 5-9, …, 80-84, 85 and older). This indicator is relevant because cancer is a leading cause of death and it is important to identify cancers separately to better target interventions. In Santa Fe, the cancer incidence rate per 100,000 population is 322.0. It is lower than that of New Mexico, which stands at 374.3.
  3. Depression (Medicare population): This indicator reports the percentage of the Medicare fee-for-service population with depression. The percent of the inhabitants of Santa Fe with depression is 15.2%. This is lower than the percentage of New Mexico, which is at 16.1%.

Social and economic factors

Economic and social insecurity often are associated with poor health. Poverty, unemployment, and lack of educational achievement affect access to care and a community’s ability to engage in healthy behaviors. Without a network of support and a safe community, families cannot thrive. Ensuring access to social and economic resources provides a foundation for a healthy community.

  1. Children eligible for free/reduced price lunch: Within Santa Fe 12,488 public school students or 61.55% are eligible for Free/Reduced Price lunch out of 20,289 total students enrolled. This indicator is relevant because it assesses vulnerable populations which are more likely to have multiple health access, health status, and social support needs. Additionally, when combined with poverty data, providers can use this measure to identify gaps in eligibility and enrollment.
  2. Education – Bachelor’s degree of higher: 40.91% of the population aged 25 and older, or 44,908 have obtained a Bachelor’s level degree or higher. This indicator is relevant because educational attainment has been linked to positive health outcomes
  3. Households with no motor vehicles: This indicator reports the number and percentage of households with no motor vehicle based on the latest 5-year American Community Survey estimates. The percentage of households with no motor vehicles is 3.59%. This is lower than that of New Mexico, which stands at 5.81%.

Physical environment

A community’s health also is affected by the physical environment. A safe, clean environment that provides access to healthy food and recreational opportunities is important to maintaining and improving community health.

  1. Air quality – particulate matter 2.5: This indicator reports the percentage of days with particulate matter 2.5 levels above the National Ambient Air Quality Standard (35 micrograms per cubic meter) per year, calculated using data collected by monitoring stations and modeled to include counties where no monitoring stations occur. This indicator is relevant because poor air quality contributes to respiratory issues and overall poor health. The percentage of days exceeding standards, population adjusted average is 0.00%.
  2. Built environment – broadband access: This indicator reports the percentage of population with access to high-speed internet. Data are based on the reported service area of providers offering download speeds of 25 MBPS or more and upload speeds of 3 MBPS or more. This data represents both wireline and fixed/terrestrial wireless internet providers. Cellular internet providers are not included. This indicator is important because access to technology opens up opportunities for employment and education. Santa Fe has a 98.13% of population with an access to DL Speed above 25MBPS.
  3. Built Environment – recreation and fitness facility access: This indicator reports the number per 100,000 population of recreation and fitness facilities as defined by North American Industry Classification System (NAICS) Code 713940. This indicator is relevant because access to recreation and fitness facilities encourages physical activity and other healthy behaviors. Santa Fe has a rate of 17.34 per 10,000 people.,

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Disease Distribution and Management
Disease Distribution and Management

Part 2

The percentage of adults aged 18 and above who have been told they have asthma is 12.40%. the adjusted incidence rate per 100,000 people shows that about 322 have cancer. This rate is lower than that of New Mexico which stands at 373.3 per 100,000 people.  The commonly diagnosed cancers are: breast, prostrate, lung and bronchus, colon, and rectum, and bladder cancer. About 14.2% of adults aged 20 and older have been reported to have a body mass index greater than 30.0 in Santa Fe. This is lower than the case of New Mexico, which has 26.6% of adults having a body mass index higher than 30.0.

Rubric

 0 Not Present1 Needs Improvement2 Meets Expectations3 Exceeds Expectations
Sub-Competency 1: Analyze community health needs using public health and clinical data.
Learning Objective 1.3: Describe the socio-demographic characteristics of specific communities.Description of socio-demographic characteristics is missing.Description of socio-demographic characteristics is inaccurate or incomplete.    Response accurately and thoroughly describes the socio-demographic characteristics (i.e., demographic measures, social and economic factors, the physical environment, health behaviors, clinical care, and health outcomes) of Santa Fe.Demonstrates the same level of achievement as “2,” plus the following:   Response accurately describes additional data such as insurance status, community safety, access to a healthy lifestyle, and access to healthcare services.
Learning Objective 1.4: Describe the prevalence of infectious and chronic diseases in a specific community.Description of the prevalence of diseases is missing.Response is inaccurate or describes fewer than two chronic and two infectious diseases.Response accurately describes the prevalence of two chronic and two infectious diseases in Santa Fe.Demonstrates the same level of achievement as “2,” plus the following:   Response accurately compares and contrasts indicators based on the data provided.

Short Answer 3

Use this link, http://cni.chw-interactive.org/, to obtain the Community Needs Index (CNI) of Santa Fe to the two neighboring cities of Edgewood and La Cueva. Calculate the index using Dignity Health’s Community Needs Index’s (CNI) methods.

Note: Detailed instructions for the use of these tools, titled “Instructions for CHNA Map Gallery,” are available in the Assessment Materials, if needed.

  1. Click on Launch CNI. Download Google Chrome following the prompts, if needed (free).
  2. Select New Mexico (Step 1), then select Santa Fe (Step 2). Then, click Draw Map. The tool will show the CNI results for Santa Fe.
  3. Click on Show More Search Options. When the map appears, click on Click here to generate report to view the CNI for each Santa Fe ZIP code.
  4. Repeat steps 2 and 3 for Edgewood and La Cueva CNI to compare the cities and ZIP codes.
  5. Click on Click here to generate report to compare the CNI for each zip code for Santa Fe, Edgewood, and La Cueva.

Based on the information you analyzed, respond to the following:

  • Compare the CNIs of Santa Fe to the two neighboring cities of Edgewood and La Cueva, and explain what this tells you about the level of need and access to resources in Santa Fe. (2 paragraphs)

Your Response

Community Needs Index (CNI) is an easily accessible score, which independently predicts post discharge ED utilization in trauma patients. Patients who report a significant CNI score above 4 are at significantly higher risks. An accurate measurement of a community healthcare needs is the primary step towards addressing the barriers to health care access, which many people undergo. The data from the CNI offers compelling evidence for addressing socioeconomical barriers while considering healthcare policy and local healthcare planning. It helps in highlighting healthcare imbalances between geographic regions and shows the acute needs of severe notable geographies. Through it, healthcare providers. And policymakers can allocate resources where they are mostly required, with the help of a standardized qualitative tool. Santa Fe has a mean CNI score of 3.4. La Cueva is a city found in San Miguel County, while Edgewood is found in Santa Fe County. The CNI score of La Cueva and Edgewood are 3.6 and 2.6 respectively.

The data shows that La Cueva has the highest CNI score (3.6), followed by Santa Fe (3.4), and lastly Edgewood (3.4). It should be noted that the low scores like that of Edgewood does not imply there should be less attention given to the inhabitants of the city; rather, there should be a determination of what works well, which accounts for the low neighborhood score. The high score from La Cueva shows that it has higher socioeconomical barriers to care. For the three cities, Edgewood has better resource access than Santa Fe, which has better resources access than La Cueva. Lastly, it should be known that community health’s status is dependent on various factors such as quality, economic and social determinants, education heredity, individual behaviors, and the physical environment.

Rubric

 0 Not Present1 Needs Improvement2 Meets Expectations3 Exceeds Expectations
Sub-Competency 1: Analyze community health needs using public health and clinical data.
Learning Objective 1.5: Compare Community Needs Indexes (CNIs) between multiple cities.Comparison of CNI scores is missing.Comparison of CNI scores is inaccurate or incomplete.Response clearly explains relevant similarities and differences between three neighboring cities, including information about CNI scores and level of need.Demonstrates the same level of achievement as “2,” plus the following:   Response examines the methodology of CNI scores and makes the connection to the social determinants of health.

Short Answer 4

Explain the relationship between the social determinants of health and the burden of disease. (1–2 paragraphs)

Your Response

Health is impacted by various factors, which can be organized into five categories. These categories are called determinants of health. Social determinants of health contain social and economic conditions, which affect the health of communities. Burden of disease is the effect of a health challenge as measured by financial cost, morbidity, mortality, and other indicators. It is an important measure for health policies, and planning since it quantifies the total effect of health conditions on people at the population level, in a consistent and comparable manner. Social health determinants are the enablers for burden of diseases. While addressing the social determinants of health via efficient policies that are based on sound global and local evidence, the issue of diseases’ burden is solved. Health care policymakers must be in a position to generate, synthesize, and interpret evidence on social health determinants.

We all deserve to live a longer life in full health. However, not everyone is that lucky. Some communities fall ill, become severely ill, and some even die prematurely, before reaching the average expected life span. To be more precise, the burden of disease falls more heavily on some populations than others. For equitable outcomes, there are various supports needed by health policy makers. The first support required is handling the social determinants of health. Solving the problem of disease burden solves the challenges of social determinants of health, and vice versa. This explains the relationship between SDH and burden of disease.

Rubric

 0 Not Present1 Needs Improvement2 Meets Expectations3 Exceeds Expectations
Sub-Competency 2: Explain the relationship between the social determinants of health and the burden of disease.
Learning Objective 2.1: Explain the relationship between the social determinants of health and the burden of disease.Explanation of the relationship between social determinants of health and the burden of disease is missing.Explanation of the relationship between social determinants of health and the burden of disease is inaccurate or incomplete.Response clearly explains the relationships between the social determinants of health and the burden of disease.Demonstrates the same level of achievement as “2,” plus the following:   Response effectively correlates social determinants of health to health outcomes and health equity.

Use the data presented in The Robert Wood Johnson Foundation’s interactive tool for sexually transmitted infections (STIs) in Virginia (2014) to answer items 5 through 7. The map can be accessed via this link:

http://www.countyhealthrankings.org/app/virginia/2014/measure/factors/45/map?sort=sc-2

Short Answer 5

Looking at the map, describe the geographic distribution of chlamydia in Virginia. Which county in Virginia has the highest rates and which has the lowest? Hint: click on the Data tabunder the heading “Sexually Transmitted Infections” to view data by county. (1 paragraph)

Your Response

Chlamydia cases are linked with unsafe sexual indulgences. Generally, Sexually Transmitted Infections have high economic burden to a country. For instance, in 2008, the direct medical costs of managing STIs and their complications in America was about 15.6 billion dollars. From the data, Petersburg City has the highest rate of Chlamydia cases (1,859). The county with the lowest cases is Buchanan (55). The range of Chlamydia case in Virginia is from 55 to 1,859. Overall, the value is 449.

Rubric

 0 Not Present1 Needs Improvement2 Meets Expectations3 Exceeds Expectations
Sub-Competency 3: Analyze data related to disease distribution.
Learning Objective 3.1: Use data to make comparisons about disease distribution.Description of disease distribution is missing.Description of disease distribution is either inaccurate or incomplete.Response appropriately uses data to describe disease distribution, including information about highest and lowest rates.Demonstrates the same level of achievement as “2,” plus the following:   Response uses data to compare chlamydia rates with three additional counties.

Short Answer 6

Examine the trend data for Fairfax County. What does it tell you about changes over time in the county’s chlamydia rates? How have chlamydia rates changed over time in the state of Virginia as a whole? (1 paragraph)

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Disease Distribution and Management
Disease Distribution and Management

Your Response

There is an increasing trend for the cases of Chlamydia in the county of Fairfax. In the year 2010, the county cases stood at 139.7, in 2014, the cases were 152. In 2016, the county cases were 259.0. This shows an increasing trend. The cases are increasing every year.  Generally, there has been a significant increase in the cases of Chlamydia in Virginia. This is mostly evident in the Northern Virginia area; whose cases are in the rise. However, considering the areas of the Greater Hampton Roads, the cases are insignificantly decreasing. 

Rubric

 0 Not Present1 Needs Improvement2 Meets Expectations3 Exceeds Expectations
Sub-Competency 3: Analyze data related to disease distribution.
Learning Objective 3.2: Interpret data to make inferences about changes in disease distribution.Analysis of data about changes in disease distribution is missing.Response describes data but makes inaccurate or incomplete inferences about changes in disease distribution.Response appropriately analyzes data to make accurate inferences about changes in disease distribution.    Demonstrates the same level of achievement as “2,” plus the following:   Response accurately analyzes chlamydia risk factors and health behaviors.
Learning Objective 3.3: Compare disease distribution at the local and state level.Comparison of disease distribution at the local and state level is missing.Comparison of disease distribution at the local and state level is inaccurate or incomplete.Response compares general disease distribution trends at the local and state level.Demonstrates the same level of achievement as “2,” plus the following:   Response includes an accurate analysis and comparison of the changes in STI rates over time utilizing statistical data at the local, state, and national level.

Short Answer 7

Based on the morbidity rates and associated coloring on the map of Virginia, where would you deploy a mobile unit for STI screenings? Explain why and the significance of the color gradient. (1–2 paragraphs)
Hint: click on Map tab under the heading “Sexually Transmitted Infections” to return to the original map, or click on the following link: http://www.countyhealthrankings.org/app/virginia/2014/measure/factors/45/map?sort=sc-2.

Your Response

From the map, there are specific places I would place the mobile unit for STI screenings. Some of these areas include: Essex, Accomack, Northampton, Prince Edward, Halifax, Brunswick, Suffolk, and Sussex. These are areas that have recorded higher county cases of Chlamydia. For the Southern part, the mobile unit would be placed at Prince George. This is an area with about 1,242 cases per 100,000 people. I would act as the best place to locate the mobile unit. All the counties from the southern part would visit this particular county for testing.

In this case, color gradient would be used to specify a range of position-dependent colors, used to fill different regions/counties of Virginia. Through gradients, readers’ eyes relax as they gradually transition through the page. In this case, the color gradients are used to specify the areas with high prevalence of Chlamydia. Those areas with few cases are given lighter colors. However, those with higher cases are given colors of greater intensity.

Rubric

 0 Not Present1 Needs Improvement2 Meets Expectations3 Exceeds Expectations
Sub-Competency 3: Analyze data related to disease distribution.
Learning Objective 3.4: Use data to make recommendations to improve health outcomes.Recommendations regarding the deployment of mobile units for STI screenings are missing.Recommendations regarding the deployment of mobile units for STI screenings are incomplete or not supported by references to the data.Response makes clear recommendations regarding the deployment of mobile units for STI screenings.    Demonstrates the same level of achievement as “2,” plus the following:   Response uses data to thoroughly and accurately justify the recommendation.

Use the CDC map of “Diagnosed Diabetes Percentage, 2011” to answer the items 8 through 10:

http://www.cdc.gov/diabetes/atlas/countydata/atlas.html

Note: Detailed instructions for the use of these tools, titled “Instructions for CDC Diabetes Site,” are available in the Assessment Materials, if needed.

  • Move cursor to 2011.
  • Click on Select State button à State Name à California.
  • Move cursor to 2010 to respond to questions.
  • Return to the U.S. map view by clicking Select State à Remove Filter.
  • Move the cursor to each year referenced in the question prompt.

Short Answer 8

Describe the geographic distribution of diabetes in the United States in 2011. Then, select the state of California for the year 2010. Describe the distribution of diabetes in California. (1 paragraph)

Your Response

Nationally, cases of Diabetes have been increasing for the adults aged 18 years and above. The national percentage for the year 2011 was 8.4%. The diabetes percentage for male is 9.0% while that of the female is 7.9%. with reference to ethnicity, Black registered the highest diabetes rate of 12.4% followed by the Hispanics (11.9%), Asians (8.5%), and lastly the Whites (7.8%). In the same year, California had a diabetes percentage of 8.4%. Males registered the highest percentage (9.1%), while the female registered a percentage of 7.8%. The county that registered the highest rate was Lake County (9.8%), and the county that recorded the slowest rate was Butte County (8.7%).

Rubric

 0 Not Present1 Needs Improvement2 Meets Expectations3 Exceeds Expectations
Sub-Competency 3: Analyze data related to disease distribution.
Learning Objective 3.5: Use data to describe disease distribution.Description of disease distribution is missing.Description of disease distribution is inaccurate or incomplete.Response appropriately describes the geographic disease distribution using visual and directional geographic references with no statistics present.Demonstrates the same level of achievement as “2,” plus the following:   Response includes specific statistics to support Descriptions provided.

Short Answer 9

Examine the national maps of diabetes from 2004 through 2010. Describe the changes in diabetes prevalence/incidence over time in the United States. (1–2 paragraphs)

Your Response

There have been changes in diabetes prevalence from 2004 to 2010 in United States. In the year 2004, the percentage of those who had diabetes was 7.4%. This value was the same in 2005, however, in 2006, the value increased by about 1.1%, making it 8.5%. In 2007, the value reduced to 7.8%. This value increased to 8.7%. in the year 2008. In 2009, there was an increase in the value to 9.2%. There was a slight decrease in the value to 8.6% in 2010. Generally, observing the trend, there has been a significant increase in diabetes cases in United States. There are a lot of factors that could have contributed to this, some of them being level of education, incomes, and the food taken by the residents.

Rubric

 0 Not Present1 Needs Improvement2 Meets Expectations3 Exceeds Expectations
Sub-Competency 3: Analyze data related to disease distribution.
Learning Objective 3.6: Analyze data to make inferences about changes in disease distribution.Analysis of changes in disease distribution is missing.Response makes inaccurate or incomplete inferences about prevalence/incidence of diabetes over time.Response appropriately describes prevalence/incidence of diabetes over time.Demonstrates the same level of achievement as “2,” plus the following:   Response accurately identifies statistics for each year and any significant or unexpected changes in the data.

Short Answer 10          

How do the rates of diabetes in California compare to the nation as a whole? (2–3 sentences)

Your Response

The rate of diabetes in California almost resembles that of the national. For instance, both California and the nation recorded the same rate of diabetes in 2011 (8.4%). There is a significant increase in the rate of diabetes for both California and United States as a whole.

Rubric

 0 Not Present1 Needs Improvement2 Meets Expectations3 Exceeds Expectations
Sub-Competency 3: Analyze data related to disease distribution.
Learning Objective 3.7: Use data to compare disease distribution at the local, state, and/or national level.Usage of data to compare disease distribution at various levels is missing.Usage of data to compare disease distribution at various levels is inaccurate or incomplete.Response appropriately uses data to compare disease distribution at the state and national level.Demonstrates the same level of achievement as “2,” plus the following:   Response uses data to compare disease distribution by sex.

Use the “BRFSS Prevalence and Trends Data by State” (http://www.cdc.gov/brfss/brfssprevalence/) to answer the items 11 through 13.

Note: Detailed instructions for the use of this web tool, titled “Instructions for BRFSS Prevalence and Trends Data by State” are available in the Assessment Materials, if needed.

Short Answer 11

What were the five most prevalent chronic diseases among the population of Alabama in 2012 based on the chronic health indicators listed?

Your Response

Arthritis: the number of adults who have been told they have arthritis was 33.9% with the value of 4009.

Asthma: the adults who have been told to currently have asthma has a percentage of 8.6%. Those who have ever been told they have asthma have a percentage prevalence of 13.5%.

Cardiovascular disease: in this case, there are three questions that have been asked. Those who have ever been told to have had angina or coronary heart disease have a percentage of 5.6%. Those who have been told to have a heart attack have a percentage of 5.8%. Lastly, those who have been told to have had stroke have a percentage of 4.6%^

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Disease Distribution and Management
Disease Distribution and Management

COPD: those who have been told to have COPD registered a prevalence percentage of 9.9%.

Depression: those who have been told to have a form of depression had a prevalence percentage of 21.9% in the year 2012.

Rubric

 0 Not Present1 Needs Improvement2 Meets Expectations3 Exceeds Expectations
Sub-Competency 4: Analyze leading causes of death and disease in the United States.
Learning Objective 4.1: Identify top chronic diseases in specific populations.Identification of top chronic diseases is missing.Identification of top chronic diseases is inaccurate or incomplete.Response accurately identifies the five most prevalent chronic diseases among the population in Alabama in 2012.Demonstrates the same level of achievement as “2,” plus the following:   Response includes a description of prevalence rates for the five most prevalent chronic conditions.

Short Answer 12

How do the rates for the five most prevalent chronic diseases among the population of Alabama in 2012 compare to the five most prevalent chronic diseases in Illinois in the same time period? (1–2 paragraphs)

Your Response

In Illinois, adults who have been told to have arthritis have a prevalence of 25.4%. This is lower than that of Alabama which is 33.9%. Those who have been told they currently have asthma have a percentage of 8.5%, while adults that have ever been told to have asthma have a percentage of 12.6%. These prevalence rates are also lower than the rates for Alabama, which stands at 8.6% and 13.5% respectively. Those who have been told to ever have had coronary heart disease or angina have a prevalence of 4.3%, those who have been told to have had a heart attack has a rate of 4.3%, and those told to have ever had stroke has a rate of 2.7%. This is also lower when compared to the rates of Alabama which are 5.6%, 5.8%, and 4.6%. The prevalence of those who have ever been told to have COPD in Illinois is 6.0% which is lower than that of Alabama, 9.9%. Lastly, the prevalence of those who have ever been told to have a form depression is 15.0% for Illinois. This is lower than that of Alabama which is 21.9%.

Rubric

 0 Not Present1 Needs Improvement2 Meets Expectations3 Exceeds Expectations
Sub-Competency 4: Analyze leading causes of death and disease in the United States.
Learning Objective 4.2: Compare leading chronic diseases between the states.Comparison of chronic diseases between the states is missing.Comparison of chronic diseases between the states is incomplete or inaccurate.Response describes chronic-disease prevalence for the leading five diseases in Illinois and Alabama.Demonstrates the same level of achievement as “2,” plus the following:   Response uses statistics to accurately analyze chronic disease prevalence in Alabama compared to Illinois.

Short Answer 13

Create a table comparing five chronic-disease indicators of your choice for 2012 in Alabama, Illinois, California, Florida, and Hawaii. (1/2 page)
Note: You may not use diabetes (non-pregnancy related) or obesity indicators in response to this question.

Your Response

 CountryAlabamaIllinoisCaliforniaFloridaHawaii
Chronic-disease indicatorsQuestions and % prevalence     
ArthritisAdults who have been told they have arthritis33.9%25.4%22.0%26.4%20.3%
Skin cancerEver told you had skin cancer?7.7% 5.2%8.3%4.1%
DepressionEver told you have a form of depression21.9%15.0%11.7%16.9%11.5%
AsthmaAdults who have been told they currently have asthmaAdults who have ever been told they have asthma8.6%   13.5%8.5%   12.6%8.8%   14.4%  8.2%   12.6%  8.9%   14.3%  
Cardiovascular infectionEver told you had angina or coronary heart disease?Ever told you had a heart attackEver told you had a stroke?5.6%   5.8% 4.6%4.3%   4.3% 2.7%3.4%   3.1% 2.3%5.9%   5.7% 3.1%2.8%   3.3% 3.0%
       

Rubric

 0 Not Present1 Needs Improvement2 Meets Expectations3 Exceeds Expectations
Sub-Competency 4: Analyze leading causes of death and disease in the United States.
Learning Objective 4.3: Organize data using a table to compare leading chronic diseases between states.Table or comparison is missing.Table is incomplete or inaccurate.Table accurately displays data comparing five chronic-disease indicators for 2012 in Alabama, Illinois, California, Florida, and Hawaii.    Demonstrates the same level of achievement as “2,” plus the following:   Table includes a brief narrative that draws relevant conclusions regarding the disease burden as a whole among the five states.

Related FAQs

1. How are diseases distributed in the world?

in the world. It is made regional geographical overv iew of distribution of diseases in the worldwide regarding to natural (terrain, climate, hydrographic and biogeographic) and social factors. The paper considers the environmental changes caused by extensive human impacts on the environment.

2. What are the components of disease management programs?

Components of disease management programs include: Population identification processes Programs designed to target individuals with specific diseases Chronic and costly… Programs designed to target individuals with specific diseases Chronic and costly conditions Evidence-based practice guidelines

3. Why is disease management important for people with chronic conditions?

People with chronic conditions usually use more health care services which often are not coordinated among providers, creating opportunities for overuse or underuse of medical care.

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