Abstract
Healthy People 2020 standards are significant in tracking progress of several heath indicators in a community with the primary aim of improving the state of health within a population of concern. For instance, access to health services as an indicator is instrumental in comparing the standards to the previous standards to track any improvements in line with the measures, objectives and goals of the standardized assessment in terms of health care sustainability. This paper will carry out assessment and diagnosis of diabetes as a health concern within the Prince Georges County among the Hispanic community. The assessment will be based on access to health services as the Healthy People 2020 indicator.
Geographical area
Hispanic community is located within the neighborhoods of Beltsville and Langley Park within the Prince Georges County. The Prince Georges County falls within the state of Maryland (United States Census Bureau, 2010).
Area size
The Prince Georges County boarders Charles County to the south and Howard County to the north and covers an area of 1,290 square kilometers which is an equivalent of 499 square miles (United States Census Bureau, 2010).
Population size
As indicated in the results of the 2010 United States Census, the Prince Georges County hosts a population of 863,420. The City of Lauderdale has a predominant population of the African American, Hispanic, and the Native American descents (United States Census Bureau, 2010).
Hispanic Demographics
The Hispanics in the Prince Georges County comprise of 123,062 persons which represents 14.9% of the entire population. The 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 years represent 9.1% of the total population. The infant mortality rates stand at 4.5 deaths per a thousand live births. This is a registered decrease from 6.4 deaths per a 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 at 2010. The average life span of the population stands at 48 years (United States Census Bureau, 2010).
Overview of the diabetes problem
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 relatively affordable by the members this community. However, the majority of the members of the Hispanic community prefer visiting these health facilities when very sick since they cannot afford regular medical checkups.
The health disparities: Diabetes as a health concern
In the last five years, the morbidity rates for diabetes within the Hispanic population have been on the rise. For instance, the incidence rate for diabetes 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 diabetes has increased from 32 per 100,000 to 48 per 100,000 from 2004 to 2010. As indicated in the government data, 69.9 percent of the diabetic population is enlisted in the affordable diabetes preventive health care services (United States Census Bureau, 2010).
Population of interest affected by diabetes
The Hispanic community in the Prince Georges County is spread unevenly. The Prince Georges County boasts of extensive settlement with each cultural group occupying different estates. Specifically, the Hispanic community occupies the neighborhoods of Beltsville and Langley Park. 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 14,000 households occupied by the Hispanics within this county. The average size of each household size is 2.8 (United States Census Bureau, 2010).
The main language spoken by this community is English and Spanish. However, some members speak French and German besides English. Due to poverty level of 20%, the average income is at $3000 per month. The household income is $32,135 while median income per family is $36,188. Per capita income is $16,775. On an average, the community literacy level is 80%. Besides, those with collage education account for 35% of the population. Seventy percent of the members of this community are Christians while 20 percent Muslims (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 diabetes are detected at advanced stages and little can be done to help this group (Allan, Ball, & Alston, 2007).
Poor income is a serious impediment towards treating diabetes and other 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 diabetes 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 diabetes reported within this population.
Diagnosis
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, occurrence of disease distribution is edged on demographic variables. Within the Hispanic community, little has been done by the locally initiated home-based diabetes prevention and treatment healthcare policy in addressing this health concern 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 the 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, 2009). A lot needs to be done towards accelerating alternatives in allocating service fee payment that may facilitate the provision of diabetes treatment and prevention services.
This should be executed within the parameters of affordability and efficiency for the Hispanic community within the Prince Georges County. There is an urgent need to improve the extended Medicare safety net to facilitate the management of Medicare for diabetes patients and their families who are equally affected. This is not the case at the Prince Georges County where little or no support is given to the affected persons taking care of the diabetes patients (United States Census Bureau, 2010).
Social justice program and rationale
From the above assessment, it is apparent that cases of diabetes have been on the rise in the recent years due to health care inaccessibility and ignorance on the side of the members of the Hispanic community. Reflectively, performance indicators in home based diabetes care are a means of fast tracking goal achievement, understanding the position of the diabetes 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 diabetes within the Hispanic community. There is need to develop a three-phased support system for the diabetic persons within this community. Due to low household income, there is need to incorporate financial, social, and preventive support to the community within volunteer and counter-prevention programs (Chisholm & Evans, 2007).
Watson’s theory of human caring reviews the necessary external elements that determine the success of human caring. The main components of the theory are nurse preparation, caring processes, and the traspersonal caring relationship. In order to achieve proper results, there is need to balance a mixture of quality, innovation, and services in social justice model. This will go a long way in managing diabetes as a health concern within the Hispanic community in the Prince Georges County.
References
Allan, J., Ball, P., & Alston, M. (2007). Developing sustainable models of rural health care: a community development approach. Rural and Remote Health, 7(5), 818- 819.
Chisholm, D., & Evans, D. (2007). Economic evaluation in health: saving money or improving care? Journal of Medical Economics, 10(1), 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. (2009). Population-Based Public Health Interventions: Practice-Based and Evidence Supported. Public Health Nursing, 21(3), 453-468.
United States Census Bureau. (2010). Prince Georges County, Maryland, U.S, 2010. Web.