Population Health Practice Problem Assignment Comprehensive Nursing Paper Sample

Population Health Practice Problem Assignment Comprehensive Nursing Paper Sample

Introduction

The primary aim of the US healthcare system is to improve the health of its populations. Population health comprises disease incidences in various groups of people. Some health issues and practice problems are common to a particular group of people. This paper investigates a population health practice problem for a particular population, assessing social determinant risk factors, epidemiological factors, evidence-based population health intervention, and relevant, measurable goals and objectives. The paper will include population description, practice problem description, epidemiology, goals and objectives, evidence-based population intervention, evaluation of the intervention, and conclusion as the subtopics.(Population Health Practice Problem Assignment Comprehensive Nursing Paper Sample)

Population

Hispanics constitute the largest minority group in the United States. They contribute significantly to the nation’s economy, health, and cultural diversity. Therefore, it is critical to evaluate health status and needs regarding social determinants, disparities, risk factors, and health services that shape morbidity and mortality. Social determinant risk factors among Hispanics include cultural sensitivity, health literacy, and shortage of Hispanic health care professionals (Velasco-Mondragon et al., 2016). Hispanics also face health inequalities linked to socioeconomic status, employment, cultural background, language barrier, and legal status. The main risk factors arising from social and economic health determinants include less education, health care access, and high poverty rates that contribute to increased risk for diseases like diabetes, obesity, hypertension, and COPD.(Population Health Practice Problem Assignment Comprehensive Nursing Paper Sample)

Practice Problem

Chronic Obstructive Pulmonary Disease and how it affects the Hispanic population

Chronic obstructive pulmonary disease (COPD) includes emphysema and chronic bronchitis, which lead to airflow blockage and other breathing problems. In 2018, COPD was the fourth leading cause of death in the US. According to Díaz et al. (2018), Chronic Obstructive Pulmonary Disease (COPD) is a severe public health issue in the United States, affecting about 28.9 million people. Recently, the burden of COPD has been more significant among Hispanics, and it is critical to research and implement public health interventions targeting Hispanic subgroups to improve COPD prevention, diagnosis, and treatment.(Population Health Practice Problem Assignment Comprehensive Nursing Paper Sample)

The significance of the practice problem at the local, regional, or national level

COPD affects the quality of life significantly. Most affected people have a limited ability to work, exert physically, do household chores, engage in social and family activities, and sleep properly. Adding to the suffering are frequent emergency department visits and hospitalization stemming from COPD exacerbations. COPD costs the United States approximately US$50 billion every year, including around $20 billion in indirect costs and another $30 billion in direct health care spending. The cost of COPD heightens with rising disease severity and hospital stay. While more than 16 million people living in America are known to have COPD, more than 26 million are known to have impaired lung function, possibly having the disease but not diagnosed. COPD has a massive economic and physical burden at the local, state, and national levels regarding financial cost, morbidity, and mortality. The current estimated COPD prevalence is over $4000 per patient every year, and the amount is expected to increase as more patients emerge presenting with lung function impairment.(Population Health Practice Problem Assignment Comprehensive Nursing Paper Sample)

The prevalence of the practice problem at the local, regional, or national level

COPD prevalence can be analyzed as two different diseases, Chronic Bronchitis and Emphysema. In 2018, 9.0 million American adults, or 3.6% of individuals aged 18 or older, had Chronic Bronchitis. The disease rates were higher among Non-Hispanic Whites than the rest of the racial and ethnic groups, women than men, and individuals aged 65 years and over. From 1999 to 2018, chronic bronchitis prevalence rates have fallen by 1.5% per year. In 2018, about 2.0 million US adults, or 1.6% of individuals aged 18 years and over, were diagnosed with emphysema. The rates were more significant among Non-Hispanic Whites than other groups, men than women, and among individuals aged 65 years and over than those below 65 years. In the last two decades, emphysema rates have increased among women and decreased among men. In 2019, the age-adjusted death rate for COPD was 40.5 per 100,000 men and 35.3 per 100,000 women.(Population Health Practice Problem Assignment Comprehensive Nursing Paper Sample)

Epidemiology

The epidemiologic principles and measures used to address COPD

Epidemiology and health surveillance are essential in providing timely and reliable information. The information is vital in detecting and mitigating diseases among specific populations (Richards et al., 2017). This discussion applies the epidemiological and health surveillance concepts to COPD among the Hispanic population. The importance of epidemiological surveillance is to provide and assess data associated with COPD to prevent and control the disease. The epidemiological principles and measures used to address COPD are the person (who), place (where), time (when), causes, risk factors, and transmission modes (why/how).(Population Health Practice Problem Assignment Comprehensive Nursing Paper Sample)

The use of descriptive and/or analytic epidemiology to address COPD

Descriptive epidemiology involves the generation of hypotheses on risk factors and causes of COPD. In contrast, analytical epidemiology entails testing hypotheses by evaluating COPD determinants, focusing on risk factors and causes, and examining COPD distribution. Descriptive epidemiology addresses COPD by focusing on its distribution by characteristics associated with time, place, and people(Population Health Practice Problem Assignment Comprehensive Nursing Paper Sample). It can help evaluate and identify what, who, when, and where COPD can occur. Analytical epidemiology address COPD by measuring the association between exposures and COPD, using information gathered from individuals instead of the aggregate population. This method helps determine why and how COPD occurs.(Population Health Practice Problem Assignment Comprehensive Nursing Paper Sample)

How to use surveillance to influence the determinants of health and improve the health outcomes of the Hispanic population

Health surveillance data provides insights into COPD’s current status. Surveillance data can be analyzed to provide information on current social, health, and economic issues leading to high Chronic Obstructive Pulmonary Disease (COPD) rates and relevant causes. Equally, health surveillance data provides statistics and information on health determinants, status, and outcomes for the target population (Groseclose & Buckeridge, 2017). Health experts can use the information to develop health policies and programs to reduce the risk of COPD among the Hispanic population.(Population Health Practice Problem Assignment Comprehensive Nursing Paper Sample)

Ethical concerns that might have related to the use of surveillance data among the Hispanic population

The ethical concerns associated with public health surveillance stem from trustworthiness. Individuals within a community accept contributing to the health surveillance scheme when they trust that the information collected will be crucial to improving their health (Klingler et al., 2017). (Population Health Practice Problem Assignment Comprehensive Nursing Paper Sample)Other factors such as solidarity with the target population, accountability, common good, and respect for rights influence the reliability of surveillance data. Contrarily, distrust can limit health surveillance, resulting in unreliable data.(Population Health Practice Problem Assignment Comprehensive Nursing Paper Sample)

Goal and Objective

Healthy People 2030 goal that addresses COPD

COPD is among respiratory diseases that affect millions of US citizens. Healthy People 2030 seeks to improve respiratory diseases prevention, detection, and treatment. The Healthy People 2030 goal that addresses COPD is “reduce deaths from COPD in adults – RD-05.” Most recent data (2019) shows that COPD has a death rate of 105.6 deaths per 100,000 adults. The target was to reach 107.2 deaths per 100,000. The desired goal was attained, but Healthy People 2030 still aims to reduce deaths from COPD even further.(Population Health Practice Problem Assignment Comprehensive Nursing Paper Sample)

Measurable objective using the SMART format to help achieve the Healthy People 2030 goal that addresses COPD

The objective to help Healthy People 2030 decrease COPD-associated deaths is to enhance patient functioning to improve COPD self-management and elevate lifestyle physical activity among underserved groups of people like the Hispanic population. The objective would help evaluate the effectiveness of home-based COPD self-management initiatives. (Population Health Practice Problem Assignment Comprehensive Nursing Paper Sample)

Evidence-Based Population Intervention

Evidence-based intervention to achieve the goal and objective

Xie et al. (2020) analyze spatial trends in smoking patients among patients with COPD, ACO, and asthma to establish a relationship between smoking and COPD, ACO, and asthma prevalence. The results indicate a higher current smoker prevalence among COPD (35.5 %) (Population Health Practice Problem Assignment Comprehensive Nursing Paper Sample)and ACO patients (31.5%) compared to HHS respondents (17.9%), (p < 0.001 for both comparisons). They also found higher ever smoker prevalence in COPD and ACO patients compared to HHS respondents (COPD = 77.7% and ACO = 71.9% vs. HHS = 43.4%, p < 0.001 for both comparisons). These results demonstrate that smoking contributes to chronic obstructive pulmonary disease (COPD) and asthma-COPD overlap (ACO) significantly, primary health issues affecting the Hispanic population. Therefore, the study recommends smoking cessation as an intervention that significantly reduces the risk of COPD and ACO in the Hispanic community.(Population Health Practice Problem Assignment Comprehensive Nursing Paper Sample)

Where the selected intervention is located on the Minnesota Public Health Wheel

Smoking cessation is located at the population-based level in the social marketing intervention category of the Minnesota Public Health Wheel. Smoking is a behavioral problem, and social marketing is the most effective approach to encouraging smoking cessation to promote public health and reduce COPD risk. Social marketing strategy is predominantly preventative, and so is smoking cessation.(Population Health Practice Problem Assignment Comprehensive Nursing Paper Sample)

The objective rationale for the evidence-based intervention to address COPD

Smoking cessation is the most effective intervention for slowing down the COPD progression and lowering mortality rates in about 50% of individuals who have been diagnosed with COPD and continue to smoke. Behavioral interventions have been used to encourage smoking cessation,(Population Health Practice Problem Assignment Comprehensive Nursing Paper Sample) but 80% of the patient still smoke (Tashkin, 2015). Smoking cessation is achieved only in 3-5% of the individuals without professional help. New approaches should be developed to promote smoking cessation. One such approach combines behavioral and pharmaceutical support to increase smoking abstinence rates after six months from 35% to 55%, depending on the professional’s experience and competence.(Population Health Practice Problem Assignment Comprehensive Nursing Paper Sample)

Evaluation

How to evaluate if the intervention is efficient, effective, efficacious, and equitable

The best way to determine if the intervention was efficient, effective, and efficacious would be to evaluate the study findings’ significance, risk of bias, directness, precision, consistency, and homogeneity/heterogeneity. I will analyze if the results are consistent with other related studies and generalizability or performance in the real world. I would assess the strength of recommendation and applicability under ideal circumstances. I would assess the representativeness of the whole population to determine if the intervention was equitable. The intervention should advance equity, and it would be proper to assess its cultural appropriateness.   (Population Health Practice Problem Assignment Comprehensive Nursing Paper Sample)

Conclusion

Impact of the practice problem on the Hispanic population

COPD has been identified as a significant public health problem in the US and Latin America. Between 2007 and 2010, the age-adjusted prevalence of COPD was 5.4% for Hispanics, 14.1% for African Americans, and 15% for Non-Hispanic Whites. The recent data shows a significant difference in age-adjusted COPD prevalence, increasing for the Hispanic subgroups with 14.1% for Puerto Ricans, 9.8% for Cubans, and 4.6% for Mexicans. The COPD prevalence among the Hispanic population is statistically significant. The increasing COPD prevalence is partly explained by the social health determinants associated with the Hispanic group. Compared with other racial and minority groups in the US, Hispanics experience lower educational attainment. They are more likely to have lower income and lower health insurance rates, affecting their access to healthcare.(Population Health Practice Problem Assignment Comprehensive Nursing Paper Sample)

The Role of the Evidence-Based Intervention to Address COPD

About 10% of Hispanic adults are current cigarette smokers. Smoking is the leading cause of COPD, and it triggers COPD flare-ups. It damages air sacs, airways, and lung linings. Smokers often experience trouble moving adequate air in and out, making breathing difficult. Smokers are at an increased rate of developing COPD. Smoking cessation is the most effective intervention for slowing down COPD progression among patients. Smoking cessation would help COPD patients manage the condition and enhance their chances of recovery.(Population Health Practice Problem Assignment Comprehensive Nursing Paper Sample)

References

Díaz, A. A., Celli, B., & Celedón, J. C. (2018). Chronic Obstructive Pulmonary Disease in Hispanics. A 9-Year Update. American journal of respiratory and critical care medicine, 197(1), 15–21. https://doi.org/10.1164/rccm.201708-1615PP(Population Health Practice Problem Assignment Comprehensive Nursing Paper Sample)

Groseclose, S. L., & Buckeridge, D. L. (2017). Public health surveillance systems: recent advances in their use and evaluation. Annual review of public health, 38, 57-79. https://doi.org/10.1146/annurev-publhealth-031816-044348

Klingler, C., Silva, D. S., Schuermann, C., Reis, A. A., Saxena, A., & Strech, D. (2017). Ethical issues in public health surveillance: a systematic qualitative review. BMC public health, 17(1), 1-13. https://doi.org/10.1186/s12889-017-4200-4(Population Health Practice Problem Assignment Comprehensive Nursing Paper Sample)

Richards, C. L., Iademarco, M. F., Atkinson, D., Pinner, R. W., Yoon, P., Mac Kenzie, W. R., … & Frieden, T. R. (2017). Advances in public health surveillance and information dissemination at the Centers for Disease Control and Prevention. Public Health Reports, 132(4), 403-410. https://doi.org/10.1177%2F0033354917709542

Tashkin, D. P. (2015). Smoking Cessation in Chronic Obstructive Pulmonary Disease. Seminars in respiratory and critical care medicine, 36(4), 491–507. https://doi.org/10.1055/s-0035-1555610

Velasco-Mondragon, E., Jimenez, A., Palladino-Davis, A. G., Davis, D., & Escamilla-Cejudo, J. A. (2016). Hispanic health in the USA: A scoping review of the literature. Public Health Reviews, 37(1). https://doi.org/10.1186/s40985-016-0043-2(Population Health Practice Problem Assignment Comprehensive Nursing Paper Sample)

Xie, S., Hubbard, R. A., & Himes, B. E. (2020). Analysis of Spatial Trends in Smoking Status Among Patients with Obstructive Airway Diseases Highlight Potential for Targeted Smoking Cessation Interventions. AMIA … Annual Symposium proceedings. AMIA Symposium, 2019, 1256–1265.

https://www.ncbi.nlm.nih.gov/

Appendix: Summary Table of the Evidence

Practice Question: Does Smoking Cessation help reduce the risk for Chronic Obstructive Pulmonary Disease (COPD) in the Hispanic community?