Community Overview
One significant finding about the Washington, DC community (ZIP codes from 20001 to 20030; population density – 11,686 people per square mile; 45.4% locals being of African-American descent) is that it is exceptionally diverse. For instance, a rather high percentage of individuals were found to have at least one family member being physically inactive (Jordan, 2015). In the metropolitan DC area, some of the respondents noted that numerous individuals in Washington, DC tend to engage in excessive drinking and have a problem with alcohol consumption in general. Outside of the given ZIP codes, the ultimate spot at the bottom of the list of the most drinking regions across DC was taken by Prince George’s County (Prince George’s County Health Department, 2016). The results of the windshield survey also make it safe to say that quite a few individuals contribute to a high rate of smoking individuals across the largest counties. Teen birth rates are somewhat higher than in neighboring counties (Asheer et al., 2020; Centers for Disease Control and Prevention, 2016). According to the majority of African-American participants of the windshield survey, DC portrays a location with a violent crime rate that is below average and does not affect the locals that much.
Another specific element that can be associated with the DC community is the lack of access to care, especially among the individuals coming from households with incomes that are below average. Insurance coverage does not protect all low-income citizens from the downsides of poverty (Remler et al., 2017; Wherry et al., 2016). The current windshield survey also leaves enough room for the conclusion that there is a high number of individuals over age 65 who can be affected by chronic diseases and the consequences of being uninsured. From the literature on the subject, it was also found that the Medicaid coverage in DC is adequate but hardly accessible due to high rates of poverty (Racine, 2016). The community can be described as affected by heart diseases, obesity, and access to care. A thorough implementation of several care programs could benefit the DC community and help the local population engage in healthier behaviors.
Strengths and Weaknesses of the Community
The essential strength of the DC community is that there is a high number of police stations and other agencies intended to protect citizens (Rock the Vote, 2021). This shows that the local government is rather focused on the provision of safety and a reasonable intensity of armed and unarmed defense in all cases. A high crime rate is predicted and prevented by such efforts, as the DC community could be negatively affected by drugs and alcohol, domestic violence, and juvenile delinquency. Another strength is that there are plenty of workplaces across the location, which means that the local government cares about providing locals with jobs and making sure that high unemployment rates can be reduced to a reasonable shortage (Hu & Wang, 2019). Ultimately, one of the biggest advantages for the DC community is a strong presence of hospitals and clinics in the region. This is a decent response to the high percentage of low-income citizens who may not be able to take care of their own health needs.
The biggest risk that is not mediated at the moment is the presence of groups of people suffering from chronic conditions. Knowing that quite a few members of the DC community cannot afford proper healthcare, this makes it essentially important to develop health promotion programs. Without a centralized approach to health issues, the community is rather likely to suffer from additional factors, such as depression, hypertension, diabetes, heart disease, and numerous other conditions. These high risks are also accompanied by a relatively elevated prevalence of crimes that could have been caused by unemployment, lack of access to care, and homelessness (Fusaro et al., 2018; Glynn & Fox, 2019). The inability to monitor and mitigate crimes could lead the DC community toward a scenario where locals would become too prone to chronic conditions, causing more confusion in the region. The ultimate weakness of the DC community is the high number of drug and alcohol abusers who could contribute to unemployment growth, depression and suicidal ideation, and school dropouts.
The Current State of Health
Behavioral Health
The first important section is behavioral health, as plenty of individuals lacking access to Medicaid or English knowledge cannot find appropriate assistance in the region. The situation is also affected by a limited presence of transitional services that could protect people with behavioral health issues from negative experiences. Even though there are supportive services for citizens with specific health needs, mental wellbeing is often overlooked as unnecessary. There are also quite a few comorbidities that might require innovative treatment options and extensive nursing knowledge. After the spread of the Covid-19 pandemic, the fundamental impact of behavioral health became even wider.
Obesity and Nutrition
There is a large number of individuals with obesity who do not request medical assistance of any kind. Inappropriate nutrition patterns are not approached across the DC community in an adequate manner either. Family-targeted interventions may be required to help the community realize the value of a healthy diet and the consumption of products that are beneficial to one’s health. Community education is one of the few strategies to aid the local healthcare stakeholders to achieve an improved state of wellbeing and reduce the number of obese citizens.
Preventative and Specialty Care
An essential point about hospitals located in the DC community area is that they are mainly focused on treatment services and do not cover preventative care to a reasonable extent. Healthy behaviors are hardly promoted among community members, so there is a need for a more detailed approach to care coordination and allocation of social services via agency involvement. More social services are crucial if the community expects to improve its preventative approaches and focus on the health literacy of all community members. DC also experiences a steep decline in professionals concentrating on specialty services. The two areas that are affecting public health among DC citizens are pain management and oncology care. The lack of partnerships between providers and stronger incentives in community-based health could be considered the main reasons for limited professional experience and a shortage in specialty care providers.
Social Determinants of Care
An essential topic of discussion that cannot be overlooked is the presence of different priorities affecting the DC community citizens since unemployment and poverty strike stronger than health issues. This can be a significant key indicator for the medical community when assessing the state of affairs in DC. The crucial impact of social determinants on a person’s health cannot be avoided because most health issues stem from problems unrelated to wellbeing in certain ways. For instance, there are numerous obstacles that could be faced by immigrants, especially when there are complex documentation requirements. Social determinants can be affected by the lack of cultural competency in care providers as well. The existing social capital should be allocated in order for the local government and healthcare stakeholders to form effective partnerships. Also, the DC community could be impacted by the limited patient and provider education in the areas of health resource usage. Patients with special needs can encounter difficulties across the DC community as well.
Elder Care and Disability Health Services
An exceptionally low level of support across the community is experienced by elderly patients and their relatives. DC community citizens do not respond to any of these limitations, so access to care among the elderly is inappropriately limited. Care management services have to be improved drastically if the DC community expects to expand its reach and provide more families with elderly patients with necessary resources. The locals could benefit from an educational program that dwells on end-of-life and elderly care. A similar approach should be taken in the area of disability services, as the DC community could benefit from broader access to various resources. Social services revolving around people with disabilities have to be aligned against their unique needs throughout any of the given life stages. In other words, assigned care providers may not be comfortable with or knowledgeable enough to treat DC residents with disabilities. Therefore, the two communities are required to exert additional efforts to voice their problems and make several additional steps toward the development of care programs that would cover their unique health needs.
Particular Community Health Issues
The three particular issues that can be pointed out when describing the DC community are cardiovascular problems, diabetes, and the lack of proper access to care. Knowing that the majority of secondary factors affect these three issues indirectly, it may be crucial to see how people’s lifestyles could be transformed to give rise to more healthy behaviors and positive patient outcomes. Diabetes and cardiovascular illnesses can be prevented by means of exercise and a rational allocation of available resources. The quality of life of the DC community should be linked to access to care, respectively. Regardless of one’s age, race, gender, or any other definitive variable, all individuals in the region should be able to cope with chronic conditions and severe illnesses with the help of care providers and government-led assistance. Citizens of any age can get exposed to issues with heart and excessive weight, so it should be crucial to develop a set of initiatives to prevent crucial scenarios from occurring across DC and the neighboring communities.
Issue Prevention and Potential Partnerships
The very first task that has to be completed when creating room for preventive actions is to communicate with the local population to learn more about their attitudes toward the observations made during the windshield survey. From evident health issues to more covert problems, the author would get an opportunity to prevent plenty of negative outcomes from happening by simply gaining insight into personal outlooks possessed by the people living in the DC community. For example, younger populations could be interviewed on the topics of access to care, substance abuse, and the possibilities and reasons for dropping out from schools and colleges. The task would be to encourage local youth to find jobs, maintain a healthy lifestyle, and stay away from violent behaviors. Different social service organizations from the region could be attracted at this point, such as the DC Department of Human Resources, for example.
Another essential task would be to set up a number of educational programs to ensure that all the required residents are going to gain access to all the relevant information. This is going to be a primary indicator of their proximity to making informed decisions regarding their lifestyle and transforming some of their habits to avoid critical health issues. From substance abuse to diet and exercise, it would be essential to educate the DC community on the majority of these issues to create an environment where transformations are going to be seen as something positive. More social service organizations could be attracted to this particular cause, such as Washington Area Intergroup Association. Personal examples from actual DC residents would be expected to make a significant impact on other people, as motivational stories bring a great deal of encouragement to the environment. Further education on heart illnesses and access to care would be required to prevent individuals from remaining uninformed and making wrong lifestyle choices.
There are two specific outcomes that have to be attained as a result of the proposed initiative across the DC community: to (1) change people’s attitudes toward their health condition and (2) decrease the number of patients with cardiovascular diseases and diabetes with the help of continuous education. As for the transformation, the essential step for the responsible stakeholders would be to communicate with various age groups from the DC community. This would help the responsible actors highlight some of the trends related to how locals react to health issues and where they tend to acquire knowledge on health-related subjects. The lack of proper education could be linked to negative patient outcomes in the future, so it is crucial to address the shortcoming today so as to protect the next generations from unexpected health issues. In order to decrease the number of people suffering from various cardiovascular diseases, the author expects to launch several educational programs free of charge so as to promote healthier lifestyles and prevent obesity and hypertension across DC.
The first intervention would be the one linked to heart diseases, where people of all ages above 25 would be eligible to participate. The team would share vital information regarding cardiovascular health over an 8-10-week period while performing regular physical check-ups to see if the intervention is effective. The main focus of the awareness program would be on the 65+ population, as older individuals tend to ignore some of the crucial health indicators and miss timely screenings in day-to-day life. Over time, the team would generate a risk map for the community and see if there are enough local resources to cope with the prevalence of hypertension and other cardiovascular issues.
Another program would revolve around diabetes and obesity awareness, with all individuals aged 15 and above would be invited to participate. The ever-increasing percentage of overweight people across the DC community makes it safe to say that there is a high risk of locals developing even more unhealthy eating behaviors and reaching inappropriate BMIs. The elevated risk of exposing one’s self to cardiovascular issues would be utilized to generate lifestyle recommendations and detailed lifestyle modification plans. The essential goal of the intervention is to inform the locals and help them revise their attitude toward their own health and body.
The last awareness program would revolve around the lack of proper access to care. Even though the metropolitan area could see insurance coverage protecting the majority of local residents, there are more than enough populations from low- and average-income households that remain uninsured and tend to ignore health interventions due to their high cost. The proposed awareness program will help the DC community residents learn more about what can be done to apply for Medicaid and other types of available insurance coverages.
References
Asheer, S., Zief, S., & Neild, R. (2020). Roadmap for effective school-based practices to support expectant and parenting youth: Lessons from the New Heights program in Washington, DC. Maternal and Child Health Journal, 24(2), 125-131.
Centers for Disease Control and Prevention. (2016).Community profile – Washington, DC. cdc.gov.
Fusaro, V. A., Levy, H. G., & Shaefer, H. L. (2018). Racial and ethnic disparities in the lifetime prevalence of homelessness in the United States. Demography, 55(6), 2119-2128.
Glynn, C., & Fox, E. B. (2019). Dynamics of homelessness in urban America. The Annals of Applied Statistics, 13(1), 573-605.
Hu, L., & Wang, L. (2019). Housing location choices of the poor: Does access to jobs matter?Housing Studies, 34(10), 1721-1745.
Jordan, C. (2015). Disability characteristics among DC residents[PDF]. District of Columbia State Data Center.
Prince George’s County Health Department. (2016). Prince George county health needs assessment [PDF]. Web.
Racine, A. D. (2016). Child poverty and the health care system. Academic Pediatrics, 16(3), 83-89.
Remler, D. K., Korenman, S. D., & Hyson, R. T. (2017). Estimating the effects of health insurance and other social programs on poverty under the Affordable Care Act.Health Affairs, 36(10), 1828-1837.
Rock the Vote. (2021). Law enforcement in Washington D.C.: An explainer. rockthevote.medium.com.
Wherry, L. R., Kenney, G. M., & Sommers, B. D. (2016). The role of public health insurance in reducing child poverty. Academic Pediatrics, 16(3), 98-104.