Lauderdale Lakes Community is located within the City of Lauderdale in Broward County in Florida. The City of Lauderdale Lakes falls within the area of the Pompano-Fort Lauderdale-Miami area (United States Census Bureau, 2010).
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The City of Lauderdale borders Lauderhill town to the west and Tamarac town to the north and covers an area of 9.43 square kilometers which is an equivalent of 3.64 square miles (United States Census Bureau, 2010).
As indicated in the results of the 2010 United States Census, the City of Lauderdale hosts a population of 32, 593. The City of Lauderdale has a predominant population of African American, Caribbean, and Jew descent (United States Census Bureau, 2010).
The African Americans in the City of Lauderdale comprise 32, 593 persons. Females are 50.2% of the population. On age distribution, persons below 6 years represent 6.8%, 6-19 years represent 14.5%, 20-64 years represent 69.6% and those above 64% represent 9.1% of the total population. The infant mortality rates stand at 4.5 deaths per thousand live births. This is a registered decrease from 6.4 deaths per thousand live births in 2000 to the current 4.5 deaths per thousand live births. The death rate per 100,000 of the population stands at 18.27 as of 2010. The average life span of the population stands at 48 years (United States Census Bureau, 2010).
Physical and social environment
There are several community health programs run by organizations within this community. The community is conscious of their health, birth control, healthy eating and living habits, and adaptation of preventive health policies. The major health services offered are relatively affordable hospital and clinical treatment, free TB and HIV centers, free post-illness recovery support, and mobile clinics. Reflectively, the government of the United States finances most of the healthcare services (Duckett, 2010). These services have been subsidized and are currently afforded by the members of this community. However, the majority of the members of this community prefer visiting these health facilities when very sick.
The Health Concern: Difficulty in Managing Chronic Ailments
In the last five years, the morbidity rates for cancer and other chronic ailments have been on the rise. For instance, the incidence rate for cancer has risen from 22 per 1000 per year in 2004 to 28 per 1000 per year in 2010. However, the prevalence rate has decreased from 20 per 1000 per year in 2004 to the present 18 per 1000 per year in 2010. The mortality rate for cancer has increased from 32 per 100,000 to 48 per 100,000 from 2004 to 2010. As indicated in the government data, 89.9 percent of the population is enlisted in the affordable cancer-preventive health care services (United States Census Bureau, 2010).
The genogram for this intervention strategy will dwell on three main building blocks. These building blocks are preventive care, home-based care, and treatment-based care. Through these elements, the partners of this project will have an opportunity to implement the triangular intervention mechanism. The output of the program will be measured by the level of positive response and the number of homes covered.
The elements of counseling home-based care and integrated community-based support played a key role in success measurement for this community as summarized in the table below.
The full genogram is attached in the appendix 1.
The population of interest affected by the Cancer menace
The African American community in the City of Lauderdale is spread evenly within the Lauderdale Lakes Community. Lauderdale Lakes Community boasts of extensive settlement with each cultural group occupying different estates. Specifically, the African American community occupies the Connecticut and Blue Hills neighborhoods. The population density of the City of Lauderdale is 8,831 per square mile. The average house unit density is 6,180 per square mile. There are 9,000 households occupied by African Americans within this city. The average size of each household size is 2.8 (United States Census Bureau, 2010).
The main source of community water supply in this community is the aquifer system runs Broward. The water originates from the Broward and is piped to the community. The city of Lauderdale community has well-maintained solid and liquid waste disposal and management authority (Duckett, 2010). The minority group in this community is the Caribbean descent that represents 10% of the entire population. The main language spoken by this community is English. However, some members speak French, Spanish, and German besides English. Due to a poverty level of 20%, the average income is $3000 per month. The household income is $32,135 while the median income per family is $36,188. Per capita income is $16,775. On average, the community literacy level is 80%. Besides, those with a college education account for 35% of the population. Seventy percent of the members of this community are Christians while 20 percent are Muslims (United States Census Bureau, 2010).
The employment rate stands at 69 percent. The informal sector accounts for 49 percent while those in the private sector account for 51%. The main means of transportation are rail and road. There are bus and shuttle services that cover all the quarters of the community. The social services include affordable education, entertainment, and parks and recreation, centers. The major employers are the government, local authorities, and private businesses(United States Census Bureau, 2010).
Since the majority of this population is relatively poor, they cannot afford constant health checkups and would only prefer the treatment-based healthcare alternative when sick. The majority of the population has not embraced the preventive health care practices characterized by visiting the hospitals for checkups even when not feeling sick. As a result of the treatment culture in seeking healthcare services, cases of cancer are detected at advanced stages and little can be done to help this group. Poor income is a serious impediment to treating cancer and other chronic ailments. Specifically, the average income is at $3000 per month which is very low. As a result, healthy living through proper dieting and canceling is largely above the reach of this group. The incidence rate for cancer has risen from 22 per 1000 per year in 2004 to 28 per 1000 per year in 2010 (United States Census Bureau, 2010). This explains the rising trend in new cases of cancer reported within this population.
The Community Resources and Partners
Among the notable partners in the fight against cancer within Lauderhill, the neighborhood is the Relay for Life, Caregiver, and Lung Cancer Alliance organizations among others. These organizations promote preventive cancer care rather than the treatment option at an advanced age. Besides, the government of the United States has enrolled a policy on chronic ailments to help curb the rising cases of cancer within this community. On the other hand, fairness involves collective consultation with stakeholders and adopting consultative decisions. Transparency involves the aspects of proactive reviews that are consistent with the performance evaluation and monitoring system (Fielding & Briss 2006).
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Reflectively, this policy contains all these aspects within its scope. Policy on cancer health care is objective and targets to make cancer and other chronic ailments healthcare provision affordable. It has specific projections and intentions that are multifaceted and based on recommendations of the stakeholders. The main components of this chronic ailment policy can be quantifiable for viability, ease of implementation, and realization of the intended goals (Olson, Susan, Marjorie & Betty 2004b). It covers the entire target population and provides room for expansion.
The epidemiological perspective views health services as insignificant in examining health status on the parameters of lifestyle, social, and economic factors. It dwells on the cause of a disease and care outcome. Basically, the occurrence of disease distribution is edged on demographic variables. Little has been done by the locally initiated home-based cancer prevention and treatment healthcare policy within the Lauderdale Lakes Community when addressing cancer health concerns on this perspective (Fielding & Briss 2006).
Economic perspective examines health service determinants such as expenditure, financial and mobilizing funds for these services. Efficiency maximization is the foundation of this dominant model. The main types of efficiencies identified in this policy include locative and technical efficiency. Therefore, this perspective aims at providing value for every monetary unit spent in healthcare provision. This monitors compliance to targets and rates (Olson, Susan, Marjorie & Betty 2004b). A lot needs to be done towards accelerating alternatives in allocating service fee payment that may facilitate the provision of cancer treatment and prevention services within affordable bundles at efficiency levels in the Lauderdale Lakes Community.
Simplifying administrative systems is vital towards reducing the high cost of cancer healthcare provision (Fielding & Briss 2006). There is an urgent need to improve the extended Medicare safety net to facilitate the management of Medicare for cancer patients and their families who are equally affected. This is not the case at the Lauderdale Lakes Community where little or no support is given to the affected persons taking care of the cancer patients.
Through subsidies on items that attract big fees to the cancer drug users, the medical providers in the Lauderdale Lakes Community will ultimately reduce consultation and medical fee. Streamlining the Lauderdale Lakes Community cancer clinics program would facilitate removal of uncommitted funding which is important in operational activities (Allan, Ball & Alston, 2007). When the activities are carried out through Medicare Network, a lot of savings will go to other supportive care activities for the cancer patients and their families. The Florida federal agency should opt for ‘active purchasing’ to leverage a secure bargaining power for the most competitive premium rates for the expensive cancer drugs to make them affordable to those fighting cancer within the Lauderdale Lakes Community (Fielding & Briss 2006).
Performance indicators in home based cancer care are a means of fast tracking goal achievement, understanding the position of the cancer policy in performance ladder, and allocating percentages as desired by the initiatives put in place. Performance plays a role in determining success, sustainability, and relevance within a competitive edge in managing cancer and other chronic ailments. When aligning opportunity cost, performance is a key indicator before deciding on the forgone alternatives (Olson, Susan, Marjorie & Betty 2004b). For instance, in the cancer healthcare sector within the Lauderdale Lakes Community, the need for cost effective healthcare management against a backdrop of affirmative action based affordable services will ensure that preventive cancer career becomes part of the health history culture for members of this community.
Through the ecological community-based approach in the cancer ailment prevention and treatment strategy, the goal would be to reduce the number of deaths caused by cancer. The objectives of this approach are sensitization of cancer towards preventive care, provision of free checks up every quarter, and fast-tracking the results of treatment through a voluntary follow-up for treating patients. Adoption of such an objective leverages health benefits to spread the cost of health recovery resulting in a pool of people (Allan, Ball & Alston, 2007). As a result, the cost per individual will substantially decrease.
Working with the community
As the nursing fraternity, it would be necessary to roll out community-based initiatives for addressing the normative and comparative needs of those infected and affected by the cancer menace. Normative needs represent the standard state of variances between a group and individuals sharing the same average summation criteria. On the other hand, a comparative need is a quantifiable discrepancy that may exist in a group as compared to others that share similar characteristics. Therefore, normative need here would be the standard of treatment for the individual asset in the service charter for addressing cancer and other chronic ailments in the community (Chisholm & Evans, 2007). The comparative need here would be spreading the intervention strategies uniformly across the subjects.
Potential Public and Private Partnerships
The potential partners for this health intervention strategy would be the local council, local self-help groups, local clinics, health centers, and government agencies concerned with chronic ailments.
Objectives for implementing these activities
The objectives of this approach are sensitization of cancer towards preventive care, provision of free checks up on a quarterly basis, and fast-tracking the results of treatment through a voluntary follow-up for treating patients.
Expected outcome timeline
|Duration||Intervention Strategy||Success measurement|
|2ndMonth to the 6thMonth||Community campaign on cancer awareness||Number of attendees during the ‘meet the community’ sessions|
|6thMonth to the 12thMonth||Addressing the normative and comparative needs of the target subjects||The response rate to strategies adopted|
|13thMonth and thereafter||Offering the home based care through partnerships||Number of persons embracing the preventive care strategies|
Within the 12 months period, I covered the preventive and treatment based case within this community as shown in the catalogue below.
|Period||Personal Initiatives||Community response|
|Ist week||Community campaign on cancer awareness||The response confirmed my assumption that low income made it difficult for the subject of study to access affordable care.|
|Last 2 days of the 2 month||Free training initiative||I managed to train 6 people from the community based organization on preventive care initiative.|
|13thMonth and thereafter||Offering the home based care through partnerships||I partnered with 10 community based organizations in the preventive care program.|
Evaluation of the outcome will encompass process evaluation, impact evaluation, and outcome evaluation of the preventive health care strategy for addressing cancer concerns within the Lauderdale Lakes Community. Process evaluation will examine actual implementation and development within a specific program. In this case, the success of evaluation will depend on the response rate to the strategies adopted to address the chronic ailments concern within the Lauderdale Lakes Community. Specifically, the success will rely on the number of persons embracing the preventive community-based health care strategy after the 12th-month mark. Reflectively, it will review the quantifiable fulfillment of targets of the program. Though done at the end of this program, it will evaluate all aspects from commencement to completion (Olson, Susan, Betty & Marjorie 2004a). On the other hand, impact evaluation will examine long-term changes that have surfaced as part of the success or failure of a project (Allan, Ball & Alston, 2007). It examines the long-term effectiveness of policy-based programs after implementation. Outcome evaluation will examine the degree of change that has been witnessed due to the successful implementation of a project.
From the above assessment, it is apparent that cases of cancer have been on the rise in recent years due to health care inaccessibility and ignorance on the side of the members of the Lauderdale Lakes Community. Through subsidies on items that attract big fees to the cancer drug users, the medical providers in the Lauderdale Lakes Community will ultimately reduce consultation and medical fees. Streamlining the Lauderdale Lakes Community cancer clinics program would facilitate the removal of uncommitted funding which is important in operational activities. Through ecological and community-based health assessment, cases of cancer and other chronic ailments would reduce substantially.
Allan, J., Ball, P., & Alston, M. (2007). Developing sustainable models of rural health care: a community development approach. Rural and Remote Health,7, 818- 819.
Chisholm, D., & Evans, D. (2007). Economic evaluation in health: saving money or improving care? Journal of Medical Economics, 10, 325-337.
Duckett, S. (2010).Governance and Relationships: Systems, Incentives and Polarities. Perth: National Congress.
Fielding, J. & Briss, P. (2006).Promoting Evidence-Based Public Health Policy: Can We Have Better Evidence And More Action? Health affairs, 25 (4), 969 – 978.
Olson K., Susan, S., Betty, L., & Marjorie, S. (2004a). Population-Based Public Health Interventions: Practice-Based and Evidence Supported. Public Health Nursing, 21, 453-468.
Olson, K., Susan, S., Marjorie, S., & Betty, L. (2004b). Population- Based Public Health Interventions: Innovations in Practice, Teaching, and Management. Public Health Nursing. 2004, 21, 469-487.
United States Census Bureau.(2010). Lauderdale Lakes city, Florida, U.S, Web.