NR 443 RN Week 1 Discussion: Social Factors

NR 443 RN Week 1 Discussion: Social Factors

NR 443 RN Week 1 Discussion: Social Factors

Professor & Class,

I live in a small community in Ohio, so I used the county I live in for my discussion.  Putnam County has a population of 33,861 persons, the median income is $62,000, and a poverty level of only 5.5%.  I feel very fortunate to live in a community/county that has many employment opportunities.  Putnam Co has 482.52 land area in square miles.  We have approximately four small family owned grocery stores and a Walmart super center in the county.  Using Walmart prices: gallon of 2% milk-2.78, loaf of wheat bread-1.78, bag of carrots-2.99, bag of fuji apples-3.99, container of yogurt-3.79, bag of doritoes-3.99, 2L of soda-1.69, and a bag of fudge strip cookies-2.50.  One social factor that determines where people shop and what people buy is income.  Although the median income in my county is high, there is a small population of people living in poverty.  At our local Walmart, groceries are considerately cheaper than the locally owned grocery store, more selection and generic items can be purchased making groceries more affordable.  Public health assumes that it is the responsibility of the community to help low income persons meet their basic needs (Nies, 2019).  My community offers resources for food assistance monies to low income families, especially infant’s formula.  Many people do not have the opportunity to buy the cookies, steak, or soda, they must categorize their needs vs. their wants.  Milk and bread may be a smarter buy this week and maybe some extra cash next week may allow the purchase of the soda.  Now with school starting back up and kids needing to pack lunches, this too plays into the necessity category.  “We know income and education fundamentally shape health through the life course and social and economic determinants matter” (Galea et al., 2020). 

Another social determinant in my community is transportation, especially in the elderly population.  Putnam Co. has an 18.8% population of persons aged 65 and older.  Because I live in an area considered a more suburban rural area, walking to local grocery stores is not an option.  Persons without transportation may have to chose to go without some items or only being able to buy a few items if having to rely on friends and family.  We do not have many options for taxi services or uber in my area, so many rely on neighbors or family member to help transport to grocery store or deliver items.  Community resources for transportation are area council on aging, and local services that offer transportation to and from areas of need like health care, groceries, and therapies. 

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Some areas that the community health nurses could address food insecurities are by screening within the community and collaboration with local primary care physician’s offices.  By collaborating with the local medical providers, patients will get screened at their health check up or routine office visit and data collected can determine the community need of social determinants.  The main goal of community health nursing is to promote the health of the community by focusing on promotion of health and health maintenance of everyone in the community (Nies, 2019).  I work in a primary care physician’s office for a large healthcare organization, we ask social determinant questions at every visit.  If the patient screens positive, we offer resources to help provide for their need.  We work closely with the local public health staff to assure the patient’s needs are met.  We may provide info on local food banks, places offering free meals, transportation, counseling options, or any other social need.  “Public and community health nursing practice includes population-focused intervention that seek to improve the health and well-being of groups, aggregates, and communities” (Nies, 2019).  The goal is to improve the future health of communities, approaching healthcare in a preventative way. 

Galea, S., Abdalla, S.M., Sturchio, J.R. (June 11, 2020). Vol. 17(6). Social Determinants of Health, data Science, and decision-making:Forging a transdisciplinary Synthesis. PLOS Medicine.

Nies, M.A., & McEwen, M. (2019). Community/Public Health nursing: Promoting the health of populations (7^th ed.). Saunders/Elsevier.

U.S. Census Bureau retrieved from  https://www.census.gov/quickfacts/Links to an external site.

Purpose

The purpose of this discussion is for learners to identify community data that impacts social factors of health.

Course Outcome

This assignment enables the student to meet the following course outcome:

• CO1 Apply principles of nursing to the public health system (PO1)

Due Date

During the assigned week (Sunday the start of the assigned week through Sunday the end of the assigned week):

• Posts in the discussion at least two times, and
• Posts in the discussion on two different days

Points Possible

100 points

Directions

• Discussions are designed to promote dialogue between faculty and students, and students and their peers. In discussions students:
  • Demonstrate understanding of concepts for the week
  • Integrate outside scholarly sources when required
  • Engage in meaningful dialogue with classmates and/or instructor
  • Express opinions clearly and logically, in a professional manner
• Use the rubric on this page as you compose your answers.
• Best Practices include:
  • Participation early in the week is encouraged to stimulate meaningful discussion among classmates and instructor.
  • Enter the discussion often during the week to read and learn from posts.
  • Select different classmates for your reply each week.

Discussion Question

There are many factors that make people healthy or ill.  This week we will focus on the social factors and determinants that impact health.

It is time to get out into your community!

• Go online to the U.S. Census Bureau at https://www.census.gov/quickfacts/ (Links to an external site.) (*note, you will be using this website in the Week 2 assignment, so you can get started on collecting all the required data if desired)
  • Input your local zip code, city, or county. Try to get as specific data as possible (city, township, county).
  • Next, identify the:
    • Total population
    • Median income
    • Percentage or number of persons living in poverty
• Go to your local grocery store, use a flyer, or app. Include the stores name, city, and state. Identify cost for the following items (please note whether items are organic):
  • 1 gallon of milk
  • 1 loaf of bread
  • 1 bag of apples (include price per pound)
  • 1 bag of carrots
  • 1 large container of yogurt
  • 1 2-liter of soda
  • 1 bag of chips
  • 1 package of cookies
• Utilizing the data collected, discuss social factors that might impact what groceries are purchased. Try to be as specific to your community as possible (location, availability, poverty levels, etc.).
• Discuss how a community health nurse (CHN) could use one of the 17 intervention categories from the Public Health Intervention Wheel to address areas of food security (Nies & McEwen, 2019).
• In your responses to classmates, include comparisons and contrasting information.

Your discussion post should look like:

• Paragraph one: Utilizing the data collected, discuss a social factor that might impact what groceries are purchased. Try to be as specific to your community as possible (location, availability, poverty levels, etc.)
• Paragraph two: Utilizing the data collected, discuss another social factor that might impact what groceries are purchased. Try to be as specific to your community as possible (location, availability, poverty levels, etc.)
• Paragraph three: Discuss how a community health nurse (CHN) could use one of the 17 intervention categories from the Public Health Intervention Wheel to address areas of food security
• Resources: Where did you find your data?

SOLUTION

• I live in Nassau County in New York City. The total population of Nassau County is 1,356,924. Females are the majority, taking 51.2% of the population. The median income is $116,100, per capita for 12 months $51,422 and the poverty level is 5.6% comparing better than that of the United States at large which is 10.5%. The whites are the majority here with 58.5% of the total population, (US Census, 2019). Situated in a busy state, Nassau has many shopping outlets and a tour of several local grocery stores such as Family Dollar and Cumberland farms helped me to identify the following prices:
  • 1 gallon of milk @ $3.25
  • 1 loaf of bread @ $2.64
  • 1 bag of apples (include price per pound) @ $1.31 organic
  • 1 bag of carrots @ $0.67
  • 1 large container of yogurt @ $2.95
  • 1 2-liter of soda coke @ $1.25
  • 1 bag of chips @ $3.78
  • 1 package of cookies @ $2.98

Social factors like the ability to prepare healthy meals are determined by an individual ability to have sufficient money and time (Nies & McEwen, 2019). Nassau County is one of the wealthiest counties in New York with more disposable income indicates that the majority of people can afford healthy food.  The number of children per household and social demographics factors such as education and gender affects the time individuals spend preparing healthy foods and observing the prices of food commodities from the stores, it’s a clear indication that even if healthy grocery such as carrots and apples are cheap and affordable people here still prefer going for snacks and fast food such as chips.

Mary requires social support; this is evident by the fact that she said she has to wait for hours before being picked or even be left out in some cases. The case scenario indicates that the culture and social system where Mary exists care less about people with disabilities. Mary stated that she could have picketed if she was in her younger age; however, she could not do that now and had to persevere. Therefore, as transport is organized, it is important to take care of the financial aspect. Mary relies on the social support both financially and emotionally.

The large transportation services carry people of different cultural and language background; therefore, appropriate communication measures must be developed to ensure that all people are treated equally. As a result, ethnic diversity and language barrier may affect the transportation system. Furthermore, there is a need to understand the needs of various clients and respond to them accordingly when picking them. For example, the drivers may be forced to help people with disability to board the bus. Cultural and social values embraced by the operators must be supportive to the people with disabilities (Simplican, Leader, Kosciulek, & Leahy, 2015).

Some of the social-cultural factors to consider in delivering the message include the fact that people raised in different environments have different values and emotional response. Therefore, the choice of words must be appropriate to ensure that the people being addressed are not offended. Understanding the cultural and social perspective towards the people with disabilities from the client’s social setting is important for effective presentation. Effective communication will be achieved by being culturally conscious and respecting all people equally.

Reference

Simplican, S. C., Leader, G., Kosciulek, J., & Leahy, M. (2015). Defining social inclusion of people with intellectual and developmental disabilities: An ecological model of social networks and community participation. Research in developmental disabilities, 38, 18-29.

4. Participation Guidelines

You are required to post a minimum of three (3) times in each graded discussion. These three (3) posts must be on a minimum of two (2) separate days. You must respond to the initial discussion question by 11:59 p.m. MT on Wednesday. Discussions for each week close on Sunday at 11:59 p.m. Mountain Time (MT). To receive credit for a week’s discussion, students may begin posting no earlier than the Sunday immediately before each week opens. For courses with Week 8 graded discussions, the threads will close on Wednesday at 11:59 p.m. MT. All discussion requirements must be met by that deadline.

Hi Dr. Pearce and Classmates,

Part A: U.S. Census Community Data

Using the latest data and estimates from the U.S. Census, Philadelphia’s statistics included:

• Total population:
  • 2019 Estimate: 1,584,064 (USA 2019 Estimate: 328,239,523)*
  • 2010 Census: 1,520,006 (USA 2010 Census: 308,745,538)
• Median Income (2018)
  • Philadelphia: $43,744 (United States: $60,293)
• Percentage living in poverty:
  • Philadelphia: 24.9% (United States: 11.8%)

*Estimated 3.8% increase in population in the city of Philadelphia comparing data from the most recent decennial census 2010 to estimates for 2019 (United States Census Bureau, 2019).

Part B: Grocery Prices

Store Referenced: Acme Markets, Philadelphia, PA (Acme Markets, 2020)

• 1 gallon of milk $4.99
• 1 loaf of bread $1.49
• 1 bag of apples $2.29     (1lb. bag)
• 1 bag of carrots $2.89     (2lb. bag)
• 1 lg container of yogurt $3.79 (32oz)
• 1 2-liter of soda $3.09
• 1 bag of chips $2.89     (9.5oz)
• 1 package of cookies $4.59

Paragraph One: Utilizing the data collected, discuss a social factor that might impact what groceries are purchased.

Despite being one of the wealthiest countries in the world and a major producer of food, the United States also experiences high levels of food insecurities. According to the data collected from the U.S. Census Bureau, 24.9% of my community is living in poverty, and as one of the most populated cities in the country, Philadelphia ranks second in the United States for this statistic. Economic instability is a social factor exposing individuals to barriers, such as accessing affordable, nutritious food. Competing expenses of rent, utilities, and medications determine food choices. Deciding to purchase less expensive items and those with longer shelf life is likely their only option. Dependence on these food selections may have a negative influence on their health over time (Oliver, et al, 2020). Another consideration is whether they have adequate kitchen supplies to prepare the food along with knowledge of meal preparation. Access to emergency food banks can assist families and provide healthier food options (Aunt Bertha, 2020).

Paragraph Two: Utilizing the data collected, discuss another social factor that might impact what groceries are purchased.

Given the inequities of poverty, another factor impacting what groceries are purchased is lack of education. Lack of basic nutrition knowledge results in poor selections. Behavior and experience impact food choices. For some, purchases are made by what looks appealing and what requires little preparation. These challenges can be further compounded if anyone in the family unit has a health condition warranting special dietary restrictions (Oliver, et al, 2020).

Paragraph Three: Discuss how the community health nurse could use one of the 17 intervention categories from the Public Health Intervention Wheel to address areas of food security.

To better understand the needs, the community health nurse could utilize screening and implement case management interventions. Bridging the gaps through access to clinical-community linkages will help support families, such as Aunt Bertha. Addressing the non-medical influencers (transportation and adequate housing) can ease the financial burden allowing for better nutritional selections.

References

Acme Markets (2020). “Shop Acme Markets.” Retrieved on 31 August 2020 from https://shop.acmemarkets.com/store/acme-markets/Links to an external site.

Aunt Bertha (2020). “Food Pantry Search.” Retrieved on 2 September 2020 from https://www.auntbertha.com/food/food-pantry–philadelphia-pa?postal=19115Links to an external site.

Oliver, T., McKeever, A., Shenkman, R., Diewald, L. (2020). “Barriers to Healthy Eating in a Community That Relies on an Emergency Food Pantry.” Journal of Nutrition Education and Behavior, 52(3), March 2020, pp. 299-306. DOI: https://doi.org/10.1016/j.jneb.2019.10.005Links to an external site.

U.S. Census Bureau (2019). “QuickFacts: United States.” Retrieved on 31 August 2020 from https://www.census.gov/quickfacts/fact/table/US/PST045219Links to an external site.?

5. Grading Rubric

Discussion Criteria	 A (100%) Outstanding or highest level of performance 	B (87%) Very good or high level of performance	C (76%) Competent or satisfactory level of performance	F (0) Poor or failing or unsatisfactory level of performance
Answers the initial graded threaded discussion question(s)/topic(s), demonstrating knowledge and understanding of concepts for the week. 16 points	Addresses all aspects of the initial discussion question(s) applying experiences, knowledge, and understanding regarding all weekly concepts.16 points	Addresses most aspects of the initial discussion question(s) applying experiences, knowledge, and understanding of most of the weekly concepts.14 points	Addresses some aspects of the initial discussion question(s) applying experiences, knowledge, and understanding of some of the weekly concepts.12 points	Minimally addresses the initial discussion question(s) or does not address the initial question(s).0 points
Integrates evidence to support discussion. Sources are credited.* ( APA format not required) 12 points	Integrates evidence to support your discussion from:assigned readings** OR online lessons, ANDat least one outside scholarly source.***Sources are credited.*12 points	Integrates evidence to support discussion from:assigned readings OR online lesson.Sources are credited.*10 points	Integrates evidence to support discussion only from an outside source with no mention of assigned reading or lesson.Sources are credited.*9 points	Does not integrate any evidence.0 points
Engages in meaningful dialogue with classmates or instructor before the end of the week. 14 points	Responds to a classmate and/or instructor’s post furthering the dialogue by providing more information and clarification, thereby adding much depth to the discussion.14 points	Responds to a classmate and/or instructor furthering the dialogue by adding some depth to the discussion.12 points	Responds to a classmate and/or instructor but does not further the discussion.10 points	No response post to another student or instructor.0 points
Communicates in a professional manner. 8 points	Presents information using clear and concise language in an organized manner (minimal errors in English grammar, spelling, syntax, and punctuation).8 points	Presents information in an organized manner (few errors in English grammar, spelling, syntax, and punctuation).7 points	Presents information using understandable language but is somewhat disorganized (some errors in English grammar, spelling, syntax, and punctuation).6 points	Presents information that is not clear, logical, professional or organized to the point that the reader has difficulty understanding the message (numerous errors in English grammar, spelling, syntax, and/or punctuation).0 points
PARTICIPATION: Response to initial question: Responds to initial discussion question(s) by Wednesday, 11:59 p.m. M.T.	0 points lostStudent posts an answer to the initial discussion question(s) by Wednesday, 11:59 p . m. MT.		-5 pointsStudent does not post an answer to the initial discussion question(s) by Wednesday, 11:59 p . m. MT.
PARTICIPATION Total posts: Participates in the discussion thread at least three times on at least two different days.	0 points lostPosts in the discussion at least three times AND on two different days.		-5 pointsPosts fewer than three times OR does not participate on at least two different days.
NOTES: * Credited means stating where the information came from (specific article, text, or lesson). Examples: Our text discusses…. The information from our lesson states…, Smith (2010) claimed that…, Mary Manners (personal communication, November 17, 2011)…. APA formatting is not required.
** Assigned readings are those listed on the syllabus or assignments page as required reading. This may include text readings, required articles, or required websites.
*** Scholarly source – per the APA Guidelines in Course Resources, only scholarly sources should be used in assignments. These include peer reviewed publications, government reports, or sources written by a professional or scholar in the field. Wikipedia, Wikis, .com website or blogs should not be used as anyone can add to these. For the discussions, reputable internet sources such as websites by government agencies (URL ends in .gov) and respected organizations (often ends in .org) can be counted as scholarly sources. Outside sources do not include assigned required readings.