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A nursing paper is an academic project assigned to student nurses. It is a general type of paper, which means instructions and contents greatly vary. Nevertheless, there are some elements common to all nursing papers and these include critical thinking, evidence from reliable sources, and high-quality discussions.

The Centers for Disease Control and Prevention [CDC] defines public health as “the science of protecting and improving the health of people and their communities” (2021). The agency further elaborates that the work of public health is “achieved by promoting healthy lifestyles, researching disease and injury prevention, and detecting, preventing and responding to infectious diseases” (CDC, 2021). Ideally, public health should be universally accessible, with outcomes more or less equally favorable regardless of populations. In reality, however, some populations are more vulnerable to certain health issues than others. Factors such as access to healthcare services, health literacy, culture, and economic conditions among others all contribute to the health of the community. The provision of public health services, therefore, necessitates the integration of community-specific factors. As one of the providers of public health, the advanced practice nurse plays a valuable role in understanding the community in order to develop public health programs tailored to meet its needs (Domm & Urban, 2020). Apart from data collection, another method to better understand the needs of specific population is surveying community health concepts. This paper looks into three health concepts related to the issue of high rate of type 2 diabetes among Canadian Aboriginal adolescents in the city of Fairfields in northwestern Canada.

Canadian Aboriginals of Fairfields

Fairfields is a small city in northwestern Canada. As of 2016, the city has a population of around 17,300. Around 4,800 or 28% of the population identify as Canadian Aboriginal. Of this, 90% identify as either Cree, Dakota, and Ojibway while the remaining 10% identify as others or mixed. Among many health issues faced by the community, one of the more pressing is the high number of Aboriginal residents diagnosed with type 2 diabetes, particularly among adolescents. According to Diabetes Canada (formerly Canadian Diabetes Association), Indigenous peoples in Canada face considerably higher risks for developing diabetes and experiencing related conditions and complications. Data shows that the prevalence of diabetes in the general Canadian population is at 5%. Prevalence is far higher among Indigenous at 17.2% among those living in reserves, 10.3% among those living off-reserve, and 7.3% among Metis peoples (Crowshoe et al., 2018). Various factors contribute to this higher prevalence such as poverty, lack of access to healthcare services, and dietary practices including frequent consumption of highly processed meat (Crowshoe et al., 2018).

Diabetes is also not limited to the adult population. Studies show that Aboriginal adolescents have higher prevalence and risk of developing type 2 diabetes. In their study involving 160 high school students in three northern Aboriginal communities, Spurr et al. (2017) found that 10% had elevated hemoglobin A1c levels. Furthermore, the study determined that 17.5% of the subjects were obese while 22.5% were overweight. Finally, 26.6% had either hypertension or prehypertension. Data in Fairfields align with national trends. A survey of 50 adolescents aged 13-21 years old living in four separate neighborhoods in the city showed that eight (12%) of them have elevated hemoglobin A1c levels. Moreover, 18 children are overweight or obese (36). These findings are concerning, especially considering how obesity are risk factors not only for diabetes but other conditions that may result in comorbidities. The high prevalence of diabetes and other health conditions among Indigenous peoples including adolescents necessitates prompt action from health providers.

Health Concepts Among Canadian Aboriginals of Fairfields

This paper explores three concepts in relation to the issue of diabetes among Canadian Aboriginal adolescents in Fairfields. The three concepts are Health Promotion, Health Literacy, and Community Resilience. Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. As the population in focus is composed of adolescents (13-21 years old) whose perception of these concepts is sometimes amorphous, the exploration will integrate perceptions of parents, community leaders, and other individuals tasked with safeguarding the health and welfare of the youth.

The first concept is health promotion. The World Health Organization [WHO] defines health promotion as “the process of enabling people to increase control over, and to improve, their health. It moves beyond a focus on individual behaviour towards a wide range of social and environmental interventions” (2021). In other words, health promotion is a comprehensive and multifactorial process intended to enhance the health status of an individual or population. In the case of Fairfields, parents, community leaders, and care providers value health promotion not just as a concept but more importantly in practice. However, the leaders acknowledge the barriers that prevent them from performing health-promoting behavior. Like many Indigenous populations across Canada, the Aboriginal community of Fairfields suffers from higher rates of poverty. The unemployment rate is at 15%, which is higher than the country’s unemployment rate in general. Average household income is also lower than non-Aboriginals. Many families rely on two or more jobs to get by, making it difficult for families to afford nutritious diets. A survey of the area also showed that there were more fast food chains than fresh produce supermarkets in predominantly Aboriginal neighborhoods. Socioeconomics is correlated with access to nutritious foods. Studies have shown that impoverished communities have more access to calorie-dense food like junk food and fast food than fresh produce since the latter tends to be more expensive and more available in affluent communities (Chen, 2016). Ultimately, the Aboriginal community of Fairfields perceives health promotion as essential to community health but is hampered by socioeconomic issues.

The second concept is health literacy, which is defined as “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions” (Ratzan & Parker, 2000). During the interviews with community leaders, it emerged that health literacy is quite low in the population in focus. As mentioned earlier, many of the parents are juggling two or more jobs to make ends meet. This has left them with little time and energy to engage with health literacy materials. Some of the parents believe that fast food offers adequate nutrition. Although the same parents wish to have the time to prepare nutritious meals for their children, they see home-cooked meals as more an opportunity to bond with and show affection for their children than a means to improve their health status. Health literacy is also lower among the adolescents themselves, who generally prefer calorie-dense food and exhibit a lack of awareness of how this type of diet can adversely affect health over time. In a way, the relatively low health literacy of the population exhibits the influence of socioeconomic status. Multiple studies have already shown that low socioeconomic status contributes to low levels of health literacy (Stormacq et al., 2019). The connection is further bolstered by the fact that most parents involved in this project have low levels of educational attainment.

Finally, the third health concept covered is community resilience. Definitions of resilience vary. Patel et al. (2017) noted the lack of a single overarching definition for this concept. However, in their systematic review of the various definitions of the concept, Patel et al. (2017) identified common elements such as networks, relationships, leadership, governance, resources, and preparedness as factors that contribute to resilience. In a way, community resilience can be generally described as the capacity of a community to overcome or adapt in response to challenges and adversities by utilizing existing tangible and intangible resources. Interaction with the Indigenous communities revealed that the population has the potential to enhance resilience. There is a strong sense of community and kinship among families and neighborhoods. For instance, residents of Oakridge, a small neighborhood just a few miles north of the city center, opened the Oakridge Children’s Daycare in 2015. The daycare is intended to look after children aged 1 to 6 years old at minimal cost to parents (fees are 58% than the nearest daycare center). Oakridge Children’s Daycare also provides freshly prepared meals to all the children. Marina Smith, the manager of the daycare, stated that the low cost was made possible because the property was leased for a peppercorn payment of $1 a year by the owners who are Aboriginals themselves. Oakridge is just one of the many organizations, both formal and informal, that have been set up in recent years to pool resources together in order to address community problems. These include soup kitchens for the homeless, a job agency for the unemployed, a drug abuse rehabilitation center, mental health referral center, and an informal school where volunteers conduct classes to teach skills. Ms. Smith acknowledges, though, that community drives like the daycare can only do so much. Real change must come from the political leadership and the establishment of policies that provide immediate relief and long-term growth for marginalized populations.

Conclusion

Aboriginal peoples have historically been among the most underprivileged and marginalized populations. The socioeconomic hardships faced by these groups often translate to poorer health outcomes. Furthermore, such struggles leave these groups vulnerable to abuse, such as in the case of the Indigenous women of Australia. This paper has put into focus health concepts related to the case of Canadian Aboriginal adolescents living in Fairfields, Canada. As with the rest of the country, Fairfields’ Indigenous population is experiencing an increase in the prevalence of diabetes among its youth, with data suggesting that as much as 12% of the 13-21-years old group have elevated hemoglobin A1c levels. The three concepts analyzed are health promotion, health literacy, and community resilience. Analysis shows that while the community values health promotion and has solid foundations that encourage community resilience, health literacy is inadequate and resources including sound health policies are scarce. The continuation of this project, therefore, must take into account these concepts in order to formulate effective and optimal strategies as well as facilitate sustainable change.

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References

Centers for Disease Control and Prevention. (2021). What is public health? CDC Foundation. https://www.cdcfoundation.org/what-public-health

Chen, W. (2016). From “junk food” to “treats”: How poverty shapes family food practices. Food, Culture & Society, 13(1), 151-170. https://doi.org/10.1080/15528014.2016.1145008

Crowshoe, L., Dannenbaum, D., Green, M., Henderson, R., Hayward, M. N., and Toth, E. (2018). Type 2 diabetes and Indigenous Populations. In Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. Diabetes Canada.

Domm, E. and Urban, A. M. (2020). Public health nurse perceptions of evolving work and how work is managed: A qualitative study. Journal or Nursing Management, 28(8), 2017-2024. https://doi.org/10.1111/jonm.13058

Patel, S. S., Rogers, M. B., Amlot, R., and Rubin, G. J. (2017). What do we mean by “community resilience”? A systematic literature review of how it is defined in the literature. PLoS currents, 9. doi: 10.1371/currents.dis.db775aff25efc5ac4f0660ad9c9f7db2

Ratzan, S.C. and Parker, R. M. (2000). Introduction. In Selden, C. R., Zorn, M., Ratzan, S. C., and Parker, R. M. (Eds.)m National library of medicine current bibliographies in medicine: Health literacy. National Institutes of Health, U.S. Department of Health and Human Services.

Spurr, S., Bally, J., Bullin, C., and Trinder, K. (2017). Type 2 diabetes in Canadian Aboriginal adolescents; Risk factors and prevalence. Journal of Pediatric Nursing, 36, 111-117. DOI: 10.1016/j.pedn.2017.05.011

Stormacq, C., Van den Broucke, S., and Wosinski, J. (2019). Does health literacy mediate the relationship between socioeconomic status and health disparities? Integrative review, 34(5), e1-e17. https://doi.org/10.1093/heapro/day062

World Health Organization. (2021). Health promotion. WHO. https://www.who.int/westernpacific/about/how-we-work/programmes/health-promotion

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