Determinants of Health Among Older Adults Essay

This is the ongoing project discussion portion of this class. My population is geriatric/elderly. The problem is BP…

I will attach previous discussions because it all needs to tie in together

350 words

at least 3 references cited in the discussion.Determinants of Health Among Older Adults Essay

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Overview: Dr. Marcia Stanhope (2020) explained that evidence-based public health practice refers to those decisions made by using the best available evidence, data and information systems and program frameworks; engaging community stakeholders in the decision-making process; evaluating the results; and then disseminating that information to those who can use the information.
Practicum Discussion: This week, your assignment will be to incorporate all of the information you have gathered from the community—including the population itself, health data, interviews/conversations with interested community members, and your community assessment, including your Windshield Survey—as well as what you have gathered from scholarly literature to propose measureable interventions. Measureable interventions mean that the results can be measured through some data that could be collected (Stanhope, 2020). This requires thinking in terms of actions and then measuring results. An evaluation of interventions is important to see whether or not they are effective in solving a health care problem. Remember, you will need to use the data you gathered to determine whether or not a problem exists in your community and to then determine whether your interventions might be effective.Determinants of Health Among Older Adults Essay

Please discuss the following points in your Practicum Discussion:

Identify one evidence-based behavior change that would promote health in your selected population.
Suggest one specific culturally sensitive, evidence-based, measureable intervention to address the health problem for your selected population.
Think in terms of measuring outcomes. What outcomes would you expect to see once the intervention(s) are in place? Be specific.
By Day 4
Post your response to this Discussion.

Support your response with references from the professional nursing literature.

GOAL of PRACTICUM PROJECT

Overall Purpose for Practicum: Develop a potential project to improve the health of a specific population of interest or a population at risk.

This practicum is designed to help you develop as a scholar practitioner and health leader to promote positive social change in your own community. In this practicum experience you will focus on primary prevention of a health problem in your community (see text for definition.) You already possess the knowledge and skills to help those who are acutely ill. This experience will help learn how to prevent a health problem in a specific population at risk at the community and system level of care (see text for definition). Consequently, because you are well aware of how to care for individuals you will now develop leadership and advocacy skills to improve the health of the community.Determinants of Health Among Older Adults Essay Collaborating with other professionals and community members in your community will be the key to a successful practicum and project. Collaborate with each other in the discussions, with your instructor, with health care professionals (nurses and other disciplines), with local and state departments of health, and most importantly with the population you hope to help. As an advocate, you will promote positive social change through collaboration with families, communities, and professionals in the health care system. You will develop a culturally relevant proposal that could improve health outcomes for a specific population at risk in your community.

WK 1

I live in a small community located in northwest metropolitan Atlanta, Georgia. The population as of 2019, was 21,760 people. The breakdown of the population is 31% under the age of 18, 14.9% 65 years or older, 51.2% are women. 73% White, 20.8% Black/African American, 12.7% Latino/Hispanic. I am currently practicing at a privately owned hospice company where we provide services to adult patients in their homes and facilities in North Georgia.Determinants of Health Among Older Adults Essay

Race is a major social determinant of health. African Americans have a higher rate of significant health problems and functional limitations. Economic resources are also a social determinant of health. As poverty increases, mortality rates increase. Economic resources are also needed to provide basic needs such as housing and food, and is required to obtain health care and medications. Social isolation and loneliness also are social determinants that have profound effects, especially during the COVID 19 pandemic.

As a hospice nurse, the majority of my patients are the geriatric population and the population at risk I am choosing to focus on for this project. The most prevalent health problems include heart disease, respiratory diseases, stroke, cancer, diabetes, and dementia. Depression is also a problem that occurs, leading to increased suicide rates of the geriatric patient. Injuries or death related to falls is a perpetual problem in the elderly. Malnutrition is widespread and seen in nearly every older patient, which is related to access to food, decreased physical ability to shop, cook, or eat. Malnutrition could also happen due to other comorbid conditions that the senior has such as dementia.Determinants of Health Among Older Adults Essay

References

U.S. Census Bureau QuickFacts: Cartersville city, Georgia. (n.d.). Www.Census.Gov. Retrieved September 7, 2020, from https://www.census.gov/quickfacts/cartersvillecitygeorgia

Equity and Social Determinants of Health Among Older Adults | American Society on Aging. (n.d.). Www.Asaging.Org. Retrieved September 7, 2020, from https://www.asaging.org/blog/equity-and-social-determinants-health-among-older-adults#:~:text=Race%20long%20has%20been%20known%20to%20be%20a

10 common elderly health issues – Vital Record. (2018, June 25). Vital Record. https://vitalrecord.tamhsc.edu/10-common-elderly-health-issues/

WK2

According to the CDC (FastStats – Hypertension, 2019), 63.1% of adults age 60 and over have high blood pressure, which is three times higher than adults aged 20-44. Georgia ranks #33rd in the nation. (Explore High Blood Pressure in the United States | 2019 Annual Report, n.d.). High blood pressure is one of the leading risk factors in heart attack and stroke.Determinants of Health Among Older Adults Essay

As a person ages, the size of the liver decreases, and the blood flow is reduced, which reduces how quickly the liver metabolizes medication. Kidney size is reduced, and blood flow is less, resulting in low renal clearance (Beers Criteria: Some Medications to Avoid in the Elderly, 2012). Because of these physiological changes, controlling blood pressure in geriatric patients can be challenging. Cognitive impairments due to age-related dementia can result in medication noncompliance and not being able to recognize symptoms of hyper/hypotension. Physical limitations result in difficulty going to regular doctor appointments, regular physical activity, and not being able to cook a healthy heart diet, all leading to uncontrolled blood pressure.

The geriatric patient needs to be closely monitored due to drug sensitivity. Because of increased sensitivity to medication, orthostatic hypotension is a significant concern for the elderly population. Orthostatic hypotension can result in falls, syncope, or death. (Arik & Yavuz, 2014)

In looking for information for this discussion, I utilized Google Scholar for my search engine. I found much of my statistics through CDC website.Determinants of Health Among Older Adults Essay

References

ARIK, G., & YAVUZ, B. B. (2014). Hypertension in Older Adults-Geriatrician Point of View. Journal of Gerontology & Geriatric Research, 03(05). https://doi.org/10.4172/2167-7182.1000182

Beers Criteria: Some Medications to Avoid in the Elderly. (2012). Tmc.Edu. https://www.uth.tmc.edu/HGEC/GemsAndPearls/medications_BeersCriteria.html

Explore High Blood Pressure in the United States | 2019 Annual Report. (n.d.). America’s Health Rankings. Retrieved September 13, 2020, from https://www.americashealthrankings.org/explore/annual/measure/Hypertension

FastStats – Hypertension. (2019). https://www.cdc.gov/nchs/fastats/hypertension.htm

WK3

We all know the top risk factors for getting or becoming more severely ill from Covid-19 include age, heart disease, or diabetes. Surprisingly, there may be a genetic link to being more susceptible or getting more severely sick from Covid-19 according to researchers. (Willingham, 2020). Researches have recently tied the severity and susceptibility of COVID-19 to two genetic links associated with a person’s immune system. One is a persons blood type, the other is a gene that regulates chemokines (Willingham, 2020). Researchers warn that this genetic knowledge is not 100% and does not factor in the social and economic inequalities that increase risk of susceptibility and severity, rather it reveals information about the disease susceptibility which may help identify therapeutic drugs to target those biological pathways and lead the way to a cure for the entire populations, not just those with specific genes (Willingham, 2020).Determinants of Health Among Older Adults Essay Chromosome 3 hold genes that encode chemokines to attract immune cells and proteins that interact with our gatekeeper into cells, angiotensin-converting enzyme 2, also known as ACE2 (Willingham, 2020). On chromosome 9 lies DNA that determines a person’s blood type. Compared with other blood types, type A are at a higher risk of getting Covid-19 and have a 1.5 times higher risk of respiratory failure and those with type O had the lowest chance of all blood types for getting Covid-19 or experiencing respiratory failure (Willingham, 2020).

By 2050 the population of adults 65 and older is expected to be 83.7 million, almost double the population in 2012 (Journal of the American Geriatrics Society). The minority population of older adults is expected to rise from 20.7% in 2012 to 39.1% in 2050 with the largest increase in Asian, Native Hawaiian, and other Pacific Islander populations , and the Hispanic population over 65 will have doubled (Journal of the American Geriatrics Society). This means that our elderly care will also have to be ethnically diverse, culturally sensitive, and unbiased.Determinants of Health Among Older Adults Essay

Culturally sensitive interventions that would be top priority would be asking the patient their preferred language and offering interpreter service in that language for any education (Journal of the American Geriatrics Society, 2016). This is important with any education but can be lifesaving for Covid-19 prevention education. It is equally important to know the patient’s education level, cognition, and hearing to ensure understanding as well as knowing if they have a surrogate or who all will be involved in decision making (Journal of the American Geriatrics Society, 2016). Customizing care to and individual’s cultural and language preferences will result in a more positive health outcome for this diverse population (Journal of the American Geriatrics Society, 2016).

Achieving High-Quality Multicultural Geriatric Care. (2016). Journal of the American Geriatrics Society, 64(2), 255-260. https://doi.org/10.1111/jgs.13924

Willingham, E. (2020). Genes May Influence Covid-19 Risk, New Studies Hint. Scientific America. Retrieved from: https://www.scientificamerican.com/article/genes-may-influence-covid-19-risk-new-studies-hint/#:~:text=Combing%20through%20the%20genome%2C%20researchers,2%20coronavirus%20into%20our%20cells Determinants of Health Among Older Adults Essay

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The Social determinants of health (SDOH) are a group of factors that impact health and wellbeing of an individual. Child development is influenced by various aspects starting from birth, biology, genetic characteristics, gender, culture and family values. The Family provides adequate support systems by various means such as socioeconomic resources, ideal family environment and effective parenting skills. A community’s health and social development depends on healthy living and health services available to them (McMurray & Clendon, 2011). The health burden of disease and causes of major health inequalities arises from the environment in which an individual is born, raised, grown and worked. Theses factors are referred to as SDOH.Determinants of Health Among Older Adults Essay

SDOH consist of a number of structural conditions. The model representing cascade of bubble demonstrates how SDOH are interrelated to each other. It is observed that if there are any political or environmental changes, all structural determinants are affected (Wilcox, 2007 as cited in McMurray & Clendon, 2011).

Primary health care (PHC) is aimed to create healthy communities. PHC approach is best described by multi-level health promotion model. Primary prevention is attained through upstream actions which are aimed to promote and maintain health. This is achieved through providing a healthy environment, health services and education for healthy living. Secondary prevention/midstream actions are providing treatment for illness and further prevention of disability. Tertiary or downstream actions are basically rehabilitation services or educating the community to cope with disability conditions (McMurray & Clendon, 2011). This essay outlines the effect of housing on health of the community. Improving the housing condition is primary prevention through upstream actions.Determinants of Health Among Older Adults Essay

To improve health and reduce inequalities, a coordinated approach is required to address SDOH which has direct effects on structural determinants. House designs should be made by taking into account health and well being. The infrastructure planning for housing designs which should include insulation, ventilation, sewage system, public spaces as well as community’s participation in their health development project should be encouraged. The health of an individual, families and the community can be improved by well designed, insulated houses and community health services. (WHO, 2011; Chapman & Bierre, 2008).

The US Centres for Disease Control and Prevention also emphasised on approach to promote health by improving housing and living conditions. The visits to emergency and stay in hospital with serious acute medical illness is shorter with improved living conditions as opposed to those who lives in poor housing (Thomson, Thomas & Petticrew, 2009; Sadowski, Kee, VanderWeele & Buchanan, 2009).Determinants of Health Among Older Adults Essay

The research study has indicated that people migrated to better housing has improved health outcomes and are also exposed to less substance abuse, violence and less neighbourhood problems as compared to their original living conditions. Government generated social and health policies directly affect the quality of life and living conditions of the community, and also the economical status of the family significantly influence an individual’s health. A co-ordinated action is required from the Policy makers, health service providers and leaders from various sectors to utilise their knowledge to enhance better living conditions bringing the best population health outcomes (Williams, Costa, Odunlami & Mohammad, 2012).Determinants of Health Among Older Adults Essay

The importance of living and working conditions, indoor environment, safe neighbourhood, healthy lifestyles in general and respiratory health in particular is a major concern these days. The predominant factors increasing the risk of asthma and respiratory problems are moisture damage in the house and bacterial growth. The studies have shown a close association between mould, dampness and asthma in children. Damp houses resulting in mould and microbial growth are the predisposing factor resulting in wheezing in adults and infants. In a survey carried in NZ homes reported 35 % of moulds clearly visible in the living area or bedrooms. NZ has been reportedly having higher asthma rates in the world, which is contributed by poor living conditions. Damp and cold houses support the bacterial growth, providing favourable media for mould, bacteria and dust mites. Young children spend more time at home as compared to adults, There is a significant effect of damp houses on respiratory system, thus the incident rate of bronchitis and wheezing illness is more common in children. It is suggested, if people will be provided with better housing and insulation, respiratory symptoms will reduce by 33% (Keall, Crane, Baker, Wickens, Chapman & Cunningham, 2012).Determinants of Health Among Older Adults Essay

It has always been stated that population of health is largely impacted by quality of housing where they live. If people living in substandard housing or poor living conditions could be provided with better housing, insulation and ventilation, It could potentially prevent ill health. There was a cluster randomised trial for housing, insulation and health study of insulating houses of communities with low socioeconomic status. A Community based approach is effective mean of improving health rather than an individual focused e.g. Insulating houses are more effective than providing people with more clothes. Older aged, infants and children spend more time in houses, thus they have to bear the physiological stress due to their weaker immune system. This research also reports an association of cold, damp houses likely to get bacterial and mould growth, eventually causing respiratory problems. Several international report highlight poor insulation, damp, cold and mouldy houses leading to poor health. People with insulated houses and better living conditions were less likely to be admitted to acute wards with pulmonary and obstructive airway diseases. The results interpreted in studies of the insulated housing affecting health were significant with improved outcome measures, except for the use of medical facilities. This study was conducted in uninsulated old houses with cold and dampness, where at least one member has respiratory problems, Increased warmth and decreased humidity brought improved health conditions. Population living in well designed and insulated houses reported significantly less cold and dampness however People in insulated houses also reported that their houses felt significantly less damp and mouldy, however this study does not determine essential determinants involved. Although this study greatly emphasise the effect of living in cold and damp houses resulting in pulmonary conditions such as asthma, cough and wheezing (Chapman et al., 2007).Determinants of Health Among Older Adults Essay

A study conducted by Kearns, Smith and Abbott on Pacific population showed substandard living conditions as compared to Maori and European population. Pacific people are at a great risk of developing asthma, cold and flu (as cited in Butler, Williams, Tukuuitonga & Peterson, 2003). Studies have reported a close relationship between cold, damp houses and respiratory diseases. Researchers also highlighted the association of poor housing with mental health and maternal health. Statistical analysis showed cold/damp houses a potential risk factor for asthma and postnatal depression. The pathophysiology of the respiratory symptoms is triggered by an allergic reaction to fungi or dust mites (Butler, Williams, Tukuuitonga & Peterson, 2003).

A major British cohort study has reported an evidence of poor living/housing conditions are growing over the life, of course, and can impose serious health effects on an individual and family. Thus, interventions to improve housing could measure better effects. Providing insulation for houses for the community with low economic conditions is a cost effective intervention to promote health and well being. It should be widely accepted by the community for their own health, policy makers and leaders to make strategy for healthy measures (Chapman et al., 2007).Determinants of Health Among Older Adults Essay

Conclusion

The health of the community is greatly influenced by SDOH more than medical care. As above stated, quality of life is significantly affected by the society and the environment in which they live and work. The burden of disease and ill health can be reduced by improving the housing environment. Medical care and accessing physician is not affordable to all, however better housing conditions can effectively reduce the financial burden on the health sector. Hence, the individual and the community should be encouraged to participate in health programmes for the promotion of their health and wellness. Determinants of Health Among Older Adults Essay