NURS 4211 – Role of the Nurse Leader in Population Health Essay

The focus of this course is on application of theories and concepts from nursing and public health sciences in assessing health status; preventing and controlling disease; and promoting a healthier population by working with families, aggregates, communities, and healthcare systems. Students apply systems thinking by using epidemiological and community assessment techniques to examine populations at risk, health promotion, and levels of prevention with special emphasis on ethnically diverse and vulnerable populations. Major local, state, and national health issues are considered including communicable disease, chronic illness, environmental and occupational health, bioterrorism, emergency and disaster preparedness, and response. Practice experiences provide learning experiences in population-based health promotion by collaborating with interdisciplinary public health partners in a local community. NURS 4211 – Role of the Nurse Leader in Population Health Essay

As a young lady that grew up in a low-income household after my mother divorced my step-father when I was 16 years old, I know all too well the socioeconomic and financial burdens these families face daily. During my windshieldsurvey, I was able to observe this community that I have been so far removed from for years,but yet there has been little change in the 13 years I have been gone. After my observationswith help from the community, I plan to bring change so other individuals like me can make it out too. NURS 4211 – Role of the Nurse Leader in Population Health Essay

Windshield Survey/ Community Assessment

In the city of McComb there are multiple apartment complexes,but in my windshield survey, I have chosen to focus on the ones that are owned and run by the government. Located on separate sides of McComb thesesapartmentsare called “projects.” The (Urban Dictionary Website, 2010) defines “projects” ashousing occupancy in which the property is owned by a central or local government authority.The website goes on to explain that the word “project” is also associated with being known as the “trap,” a “struggle,” and is often made up of people who live from paycheck to paycheck oroff of government assistance. The tenants on a daily basis are fighting to stay alive; they pretend to be blind when violent crimes occur for their and their family’ssafety.The projects are known to havea lot of “hustlin” (doing whatever a person has to do to make money),so they can make a living (Urban Dictionary, 2010). NURS 4211 – Role of the Nurse Leader in Population Health Essay

Community Parks and the McComb Housing Authority are the two housing units I in my windshield survey. They both are low-income housing, but the funding is different. Community Parks which is the worst of the two is a 120 project-based rental unit that has a Project-Based Section 8 Contract with Housing and Urban Development (HUD) that pays the majority of the tenant’s rent. Employed tenants are expected to pay at least 30% of their adjusted gross income (AGI) toward rent; other tenants must pay $25 a month regardless of income (Layfield, D., 2018). The McComb Housing Authority has a total of 3 different complexes totaling over 500 units,and they do not participate in the Section 8 Housing Choice Voucher Program. All the units are low-income housing,and they are rent subsidized, or income based. The employed tenants living here also must pay at least 30% of their AGI towards rent monthly, and all others have to pay a minimum rent up to $50 (Layfield,2018). NURS 4211 – Role of the Nurse Leader in Population Health Essay

Initially,low-income housing was implemented by the government 70 years ago to help aid Caucasianlow-income families with getting shelter due to dangerous and unclean housing environments caused by their socioeconomic and financial difficulties(Pappas A., 2013).As the years passed low-income housing in my community hasdeteriorated and is known as the “ghetto.” The “ghetto” a section of a city, especially a thickly populated slum area, inhabited predominantly by members of an ethnic or another minority group, often because of socioeconomic restrictions, pressures, or hardships(Dictionary.com., 2018).Both ofthese areas in my community are druginfested, have problems with violent crime,  and suffer tremendously due to their many socioeconomic matters. NURS 4211 – Role of the Nurse Leader in Population Health Essay

The City of McComb

McComb, MS is my hometown, and its located in the southwest part of the state. McComb was founded by Henry Simpson McComb of the New Orleans Railroad. Mr. McComb, the predecessor of the present day Canadian National Railways, (formerly the Illinois Central Railroad) did not like the city saloon lifestyle of New Orleans, so he relocated the railroad’s maintenance shops. He purchased the land that is now called McComb, MS and after doing so, he built other shops, sold them at discounted prices with the stipulation that no alcohol would be sold in the city limits (Mississippi Genealogy and History Network Executive Council [MSGHN], 2018).This area of town soon was named Downtown McComb, and business owners here were very successful due to the railroad being that close in proximity. NURS 4211 – Role of the Nurse Leader in Population Health Essay

McComb, MS is not only known for the railroad, the city also played a critical role in the Civil Rights movement during the 1960s by being the first Student Non-Violent Coordinating Committee (SNCC) voter registration project where the murder or voter registration activist Herbert Lee occurred, andwhere Brenda Travis was expelled by the Ku Klux Klan (KKK). McComb was also the place where several bombings occurred due to racism(MSGHN, 2018).

McComb, MS is in Pike County,and per the (U.S. Census Bureau, 2017) the population was 39,468 for the county. This population census is down by -23%when compared to 2010 when it was 40,407. Pike County has 44.5% of the Caucasian race, 53.6% of Black/African American race, 1.7% Hispanic/Latino race, 0.6% of the Asian race, and 0.13% of all other races combined. There are 18,441 housing units,and 68.1% are owner-occupied homes. The median household income for Pike county in 2016 was 31,511 and persons in poverty percentage were 30.1%. The percentage of individuals above 25 years old in Pike County with a bachelor’s degree or higher was 15.7% in 2017 (U.S. Census Bureau, 2017). NURS 4211 – Role of the Nurse Leader in Population Health Essay

Implications

While visiting these areas, it is obvious that economic and social factors have a significant impact on the lives of the individuals that live and that are being raised up in low-income housing projects in multiple ways. The first way is by how their environment impacts their lives daily. The occupants live in these units that have high drug and crime rates which affects theirsafety and the safety of their families. The tenants and their loved ones are at increased risk for being hurt or possibly killed because of their environmental surrounding.The next socioeconomic factor impacting this group would be the lack of resources such as transportation, medical care, and employment. Many of the families this community do not have transportation to get to the grocery store, the hospital, doctor’s appointments, and work. Unlike inmetropolitancities, Pike County does not have buses. We have one taxi cab service that is not always available. Some of the elderly get appointments set up with Medicaid transportation to get to doctor’s visits, but the downside to this is that they may get to that appointment at 8 am and not get pickedup until 4pm and make it home until 6 pm.Many of the renters depend on family and friends for transportation which is not always reliable thereby,suffering lose again. Loss of jobs because they cannot keep a job without reliable transportation. They are also unable to buy nutritious foods for themselves and their children causing them to consume foods that are bad for their health and causes malnourishment leading to greater health concerns. NURS 4211 – Role of the Nurse Leader in Population Health Essay

Finally, another socioeconomic factorthat impacts the lives of low-income families is lack of access to healthcare and insurance coverage. These tenants are live10-15 miles away from the nearest hospital and as stated before most do not have transportation and they cannot afford healthcare insurance premiums.Once the individual gets transport, they can now seek medical attention,but he/she does not have insurance or the finances to go to urgent care or a primary care physician for non-urgent medical conditions. This lack of insurance coverage then causes them to seek care in the local ER for minor complaints.To decrease the number of non-urgent cases seen in the ER, the one Trauma Level 3 hospital we have in McComb, (Southwest Mississippi Regional Medical Center) executed a program where patients with non-urgent complaints had to pay $200 upfront to be seen in the ER in 2017. Not all of the people go without health insurance; a few have Medicaid, Chips, and other health insurance provided by the government. NURS 4211 – Role of the Nurse Leader in Population Health Essay

When I assess this vulnerable population as a community, I think how we can come together and make things better. First, we need to reach out to lawmakers, starting with the local officials, to make sure that they are aware of the needs this population has and assist them in establishing resources for the community. Resources such as more programs to help the elderly in their home, get their medication, get food, get to appointments and not have to stay away from home all day after going to an 8 am appointment. Another resource would be job fairs and training to help individuals get prepared for an interview and be successful on the job. Secondly, as healthcare providers, we could offer free yearly health care screening. We could partner with the local churches in the community, go out to the housing projects, and hold health fairs several times a year on different diseases so the community can stay informed.Thirdly, with the assistance of local churches and other leaders in the community, we can host food drives and take items collected and give them to those families in need. NURS 4211 – Role of the Nurse Leader in Population Health Essay

Health is a “state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity” (Stanhope & Lancaster, 2016 p. 380). This population is very unhealthy, and it is not only in a physical disease as healthis described above.  Upon completion of my windshield survey, I noted that this population is in dire need of direction or the generation of children that I saw playing on the streets will be destined to repeat the same behaviors,and the cycle will continue.  The cycle of being dependent on government assistance, living in low-income housing where there are drugs and violence, living in communities where resources are scarce, lack of jobs, lack of health care, and lack of food. As an advanced practice nurse, I plan to give back to this community because not only did I do this survey, I use to be one of these tenants. My mom lived in the McComb Housing Authority for about five years after she divorced her husband when I was 16 years old,and I lived in Community Parks while I was in the Associate Nursing Degree program at the local junior college. Going back to do the survey was surreal for me because I was one of the ones who made it out. Everyday, I would come home to the “projects” from school it would give me the motivation to keep going because I wanted better for myself and my son. That is why I will fight for this community because it is me and I am it. NURS 4211 – Role of the Nurse Leader in Population Health Essay