Health program for children as a priority population
Children are a vulnerable population who cannot make health decisions suffer the consequence of parents who are powerless to obtain government-sponsored insurance due to lack of resource connection, language barriers, education, and inadequate support systems leaving millions of children who are eligible for healthcare support through the Medicaid/CHIP program (Flores et al., 2015). Minority single, unemployed women with children who have successfully enrolled in the Medicaid/Chip program are now trained parent mentors to guide and educate other parents increasing enrollment of the millions of children eligible for Medicaid/CHIP through educational outreach programs and has proven to be more effective than Medicaid itself (Flores et al., 2015).
The AHRQ (2010) partnered with Medicare and Medicaid Services to award contracts to the Mathematica Research and partners Urban Institute and Academy Health to evaluate qualitative and quantitative data to evaluate initiative effectiveness and the impact at the state level of the CHIP Program improving children’s health.
Eighteen states grant programs support CHIPRA (Child Health Insurance Program Reauthorization Act) with efforts in the state of North Carolina to improve healthcare for children as identified by the AHRQ (2010) are:
- Calculating – Assisting practices to strengthen medical home models of care for children with special needs.
- Reporting- Providing IT coaches to improve the efficient use of the Electronic Health Record.
- Quality Improvement Measures- Improve the numbers of children enrolled in the Medicaid/Chip Program: Maternal Screening, Autism Screening, Adolescent Psychosocial Screening, and Obesity Counseling for ages 6-10 years.
The state of NC met three of the five national goals impacting children’s health.
Equality and patient-centeredness belong to many key values in healthcare, but, as is clear from the modern facts of life and reports prepared by professional organizations, there is a lot to be done to address health disparities. The discussion above focuses on children’s situation, highlighting that the latter are incapable of making healthcare decisions on their own. In general, I agree with the majority of points concerning the disparities that children face since the author provides enough details and references credible and up-to-date sources. Importantly, the information on particular programs aimed at improving children’s access to healthcare is presented in the post.
In this response, I would like to attract more attention to disparities related to the health literacy of children’s parents. Modern researchers in the field of nursing identify various sources or disparity when it comes to children. Many of them believe that such component as parents’ health literacy often remains underestimated even though there is evidence that health literacy “may be a stronger predictor of health than race and income” (Cheng, Emmanuel, Levy, & Jenkins, 2015, p. 965). According to Cheng et al. (2015), AHRQ provides numerous recommendations on reducing these disparities; they include avoiding medical jargon in conversations with parents, using the right speech tempo, and asking clients to explain what they have just heard.
Health program for rural communities as a priority population
People of rural communities can have limited access to healthcare for reasons such as poverty, weather, lack of insurance, transportation, and distance from providers (DeNisco & Barker, 2016). Compared to people of urban areas, those who live in rural areas have a higher smoking rate, obesity rate, are poorer, are older, have more hypertension, and a shorter life expectancy (Agency for Healthcare Research on Quality [AHRQ], 2017). Some actions have been taken to address the problem of healthcare access in rural America. The identification of Health Professional Shortage Areas (HPSAs) and Medically Underserved Areas (MUAs) and the passing of the Rural Health Clinics Act are among the measures taken to combat this problem (DeNisco & Barker, 2016). One successful measure was creating the National Health Service Corps (NHSC), which used scholarships and loan repayment programs to entice health care professionals to practice in areas of need (DeNisco & Barker, 2016). This program has been in place since 1972 and is currently has approximately 10,000 medical professionals participating (DeNisco & Barker, 2016).
Addressing disparities is among the key task that modern healthcare providers should fulfill to make the approach to care provision more patient-centered. The post above contributes to discussing health disparities by focusing on the unique issues related to healthcare access that people from rural communities have. In general, I agree with the arguments provided by the student since this information comes from credible sources and does not run counter to what I see in my professional practice. As it is demonstrated in the post, the health situation of rural citizens is worse than that of people in urban areas despite better air quality. To continue the discussion and add new information about strategies aimed at reducing disparities, I would like to focus on the field of cancer research. According to Mueller-Luckey et al. (2017), the tools based on community-based participatory research can help reduce inequality. Such tools lead to the establishment of local coalitions and help compare local cancer statistics to state mortality rates, which allows setting priorities. It is important that the activity of academic community partnerships helped to make positive changes despite barriers related to the physical distance between partners and the distribution of responsibilities.
Health program for elderly people as a priority population
One of the “priority populations” listed by the AHRQ report is the elderly population. The growth of the older adult population is unprecedented in the history of the United States. According to the National Center for Chronic Disease Prevention and Health Promotion, this growth is related to two factors: (1) longer life spans and (2) the aging baby boomer population. It is estimated that by 2030 the older adult populace will account for nearly 20% of the US population (National Center for Chronic Disease Prevention and Health Promotion, 2013). Unfortunately, with longer living comes with a greater risk for chronic diseases and degenerative illnesses (i.e., diabetes mellitus, arthritis, congestive heart failure, and dementia). These individuals are also at risk for infectious diseases and acute illnesses.
According to Healthy People 2020, “preventative health services are valuable for maintaining the quality of life and wellness in older adults,” (Healthy People 2020, 2010). Federal government agencies are attempting to improve the quality of life for older adults through programs geared toward addressing chronic illnesses. Many of these programs focus on early prevention and physical activity to prevent a decline in older adult health status and decrease their risks for infectious or acute diseases. Nationwide promotion of influenza and pneumonia vaccinations in older adults is another method to prevent elderly infection. The National Institute on Aging at NIH developed websites like Go4Life, that provides the elderly population with information on healthy active living, which has the goal of improving quality of life (Healthy People 2020). So far, the US has met six of the Healthy People 2020 targets, including:
- No leisure-time physical activity in the past month
- Current smoking
- Taking hypertension medications
- Mammograms within the past two years
- Colorectal cancer screenings
According to popular opinions, the maturity of any society is defined based on the quality of care that children and older adults receive. To some extent, the discussion post above supports this position by discussing the health disparities faced by older adults in the United States. I agree with the author regarding the vulnerable position of people of advanced age and the importance of programs aimed at addressing chronic health problems. The student uses credible and up-to-date sources, which makes the most informative. I believe that it is pivotal to continue discussing health disparities in elderly people by narrowing the focus. There are numerous problems typical for all people of advanced age, but many of them also face issues specifically related to their ethnicity and language barriers. In their research, Yoo, Musselman, Lee, and Yee-Melichar (2014) prove that older adults in racial minorities such as Asian Americans have a range of unmet physical and psychological needs when it comes to the treatment of cancer and diabetes and suicide prevention. Thus, regarding all older adults in the United States as one large group makes the development of disparity reducing strategies easier, it can also pose a threat to their effectiveness because the areas of concern can greatly vary depending on ethnicity.
Flores, G., Walker, C., Lin, H., Lee, M., Fierro, M., & … Portillo, A. (2015). CHIP/Medicaid: A Successful Program for Training Parent Mentors to Provide Assistance With Obtaining Health Insurance for Uninsured Children. Academic Pediatrics, 15275. Web.
More About the National Evaluation. Content last reviewed in January 2018. Agency for Healthcare Research and Quality, Rockhill, MD. Web.
Cheng, T. L., Emmanuel, M. A., Levy, D. J., & Jenkins, R. R. (2015). Child health disparities: What can a clinician do? Pediatrics, 136(5), 961-968.
Agency for Healthcare Research on Quality. (2017). Chartbook on rural health (17(18)-0001-2EF). Web.
DeNisco, S. M., & Barker, A. M. (Eds.). (2016). Advanced practice nursing: essential knowledge for the profession (3rd ed.) Burlington, MA: Jones & Bartlett Learning
Mueller-Luckey, G. S., Zahnd, W. E., Garner, K., Heitkamp, R., Jenkins, W. D., Boehler, M. D., & Steward, D. E. (2017). The mini-report: A practical tool to address lung cancer disparities in rural communities. Journal of Cancer Education, 32(2), 293-300.
Healthy People 2020. (2010). Older adults. Web.
National Center for Chronic Disease Prevention and Health Promotion. (2013). The state of aging and health in America in 2013. Retrieved from Centers for Disease Control and Prevention. Web.
Yoo, G. J., Musselman, E., Lee, Y. S., & Yee-Melichar, D. (2014). Addressing health disparities among older Asian Americans: Data and diversity. Generations, 38(4), 74-81.