Anne Burgos RE: Week 4 Discussion

Anne Burgos RE: Discussion - Week 4 COLLAPSE Top of Form Nsg 6050-Week 4 Discussion

There are many factors that play a part in determining the health outcomes of a population. Some key determinants include access to health care, individual behavior, social environment, physical environment, and genetics. When looking at specific health issues, these determinants should be considered during the development of policy in order to improve patient and population health outcomes. One particular population health issue that has been proven to be of significant concern is hypertension, as it correlates directly with one's risk for heart disease, stroke, and other comorbidities.

According to the CDC, between 2015 and 2016, the incidence of hypertension was at 29% among Americans, with less than one-half of those individuals having their hypertension under control (Center for Disease Control and Prevention, 2017). Obvious disparities in prevalence and hypertension control were seen with varying age, race, and gender. Hypertension was seen in 33.2% of adults aged 40-59, and 63.1% of adults over 60 years old. The incidence among non-Hispanic Black individuals was significantly higher at 40.3%, while non-Hispanic whites and Hispanics had rates of 27.8%, and non-Hispanic Asians at 25% (CDC, 2017). Conversely, controlled hypertension was more evident among non-Hispanic whites at 50.8%, compared to 44.6% in non-Hispanic Blacks and 37.4% in non-Hispanic Asians (Center for Disease Control and Prevention, 2017).

These statistics raise questions about which determinants are directly related to these disparities. Access to health care is arguably the most influential determinant in population health and is prominently featured on the Healthy People 2020 agenda (U.S. Department of Health and Human Services, 2010). “Access to health care impacts one's overall physical, social, and mental health status and quality of life” (Offices of Disease Prevention and Health Promotion, 2018). Populations lacking health insurance or access to adequate health care are less likely to receive diagnoses, treatments, or medications necessary for managing hypertension effectively.

By identifying barriers to health care access, policies can be enacted to improve availability, such as through legislative acts like the Affordable Care Act. However, access alone does not guarantee that individuals will seek care. Personal behaviors significantly influence participation in routine check-ups, seeking care for symptoms, and medication adherence. It is common to encounter cases where individuals experience hypertensive crises or other health emergencies because they neglected regular health evaluations or were asymptomatic for years. Preventative health practices, such as routine check-ups, could mitigate the severity or occurrence of such health problems.

Social and physical environments are additional vital determinants. These environments influence health through factors such as education, income, housing, and neighborhood safety. In lower-income populations, limited access to nutritious food and healthcare contributes to delayed diagnoses, fewer treatment options, and worse health outcomes (Laureate Education, 2012h). For example, targeted programs in Baltimore drastically reduced sexually transmitted infections by addressing socioeconomic disparities through community interventions.

Genetics is a non-modifiable determinant but remains crucial in understanding disease predisposition. Certain populations, such as non-Hispanic Black communities, have a higher genetic predisposition to hypertension. Recognizing these genetic susceptibilities enables targeted screening, preventative efforts, and education, which can contribute to reducing disparities over time. Employing epidemiological research helps healthcare providers refine interventions and develop policies that address population-specific risks.

In summary, comprehensively addressing population health challenges requires recognizing the complex interplay of determinants—modifiable and non-modifiable—and their impact on health outcomes. Effective policies and community-based interventions that consider barriers to healthcare access, social and physical environments, individual behaviors, and genetics are essential for improving overall population health regarding conditions like hypertension.

References

• Center for Disease Control and Prevention. (2017). National Center for Health Statistics. Hypertension prevalence and control among adults: United States, 2015–2016.
• Laureate Education. (2012h). Population health. Baltimore, MD: Author.
• Office of Disease Prevention and Health Promotion. (2018). Healthy People.gov. Retrieved from https://www.healthypeople.gov
• U.S. Department of Health and Human Services. (2010). Healthy People 2020. Retrieved from https://www.healthypeople.gov
• Kindig, D., Asada, Y., & Booske, J. (2008). A population health framework for setting national and state health goals. The Milbank Quarterly, 86(1), 139-161.
• Kindig, D. (2007). Understanding population health terminology. The Milbank Quarterly, 85(1), 139-161.
• Florida Health. (2016). Collier County community health assessment.
• Florida Health. (2016). Health insurance coverage in Collier County and Florida.
• Schroeder, S. A. (2007). We can do better — improving the health of the American people. New England Journal of Medicine, 357(12), 1221–1228.
• Braveman, P., & Gottlieb, L. (2014). The social determinants of health: It's time to consider the causes of the causes. Public Health Reports, 129(Suppl 2), 19-31.