- Identify one health problem you believe to be the most prevalent in your community. You may want to check with your local health department or a community health nurse. Also consider researching the morbidity/mortality rates health problems in your community. School nurses and are an excellent resource person to contact.
- Analyze the problem using Milio’s framework for prevention from the module 1 readings (Chapter three in your text, pp 41)
- Choose one of your nursing diagnoses and describe how your identified community health problem applies.
- Consult Healthy People 2020 to find the national goals that are closely related to your chosen diagnosis (p.90)
- One long-term goal, minimum of three short-term goals and Intervention(s) (p.89)
Minimum of four (4) total references: two (2) references from required course materials and two (2) peer-reviewed references. All references must be no older than five years (unless making a specific point using a seminal piece of information)
The purpose of this paper is to discuss a prevalent health problem in Fairfield County, Ohio and discuss how Nancy Milio’s framework for prevention addresses the health care problem. The paper will incorporate the Fairfield County health challenge to my week one cardiovascular nursing diagnosis, and will cover long and short term goals and interventions as pertaining to the health care issue and in accordance with Healthy People 2020 guidelines.
Fairfield, County Ohio Community Health Problems
In week one of this class, I formulated two nursing diagnoses related to disease in Fairfield County, Ohio. One of my diagnoses focused on cardiovascular disease. Cardiovascular disease has a number of attributing factors, including hypertension, obesity, and the use of tobacco. According to a Fairfield County Community Health Assessment, in the year 2010, 23% of Fairfield County adult residents had a cardiovascular disease diagnosis, with heart disease accounting for 28% of resident deaths (Ohio Department of Health, 2016). In the same assessment, 34% of Fairfield County residents had the diagnosis of hypertension, 7% were told they were pre-hypertensive, 33% were obese, and 17% of adults reported they used tobacco (Ohio Department of Health, 2016).
Milio’s Framework of Prevention – Problem Analysis
Nancy Milio, PhD, RN, was a public health nurse who formulated a framework for prevention, which aimed to explain the connection between the individual’s state of health and that of the community (Nies & McEwen, 2015). Milio formulated six propositions in an attempt to explain the interrelation of a person’s choices as they corresponded to the resources available in the community. In researching the topic of cardiovascular disease, I saw three specific Milio-propositions could be applied to my county.
In her first proposition, Milio theorized that a person’s state of health is directly influenced by too little or not enough of health-sustaining resources (Milio, 1976). Milio reported that the affluent members of her 1976 society indulged in too much food, soda pop, and alcohol. Similarly, in 2017, people are likely to indulge in the convinces of fast food restaurants, soda machines in every breakroom, and drive through liquor stores. Fast food is not only convenient; thanks to dollar menus, it is affordable even to lower income individuals. Most meals have the option to super-size the French fries and soda. In my city, there are two fast food restaurants directly across the street from the high school. Each restaurant is packed at lunch time with high school students escaping the cafeteria for cheap fried foods and caffeinated drinks. Regular consumption of foods high in carbohydrates, fat, salt, and sugar largely contribute to hypertension and obesity, leading factors of cardiovascular disease (Pencak Murphy, Coke, Staffileno, Robinson, & Tillotson, 2015).
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Milio’s second proposition stated that a person forms habits based on their actual or perceived choices. In the example above, the high school students flocked to the fast food restaurants at lunch for a variety of reasons. The restaurants are easily accessible, the food is fast and cheap and the student may perceive no other option for lunch. Going out to lunch with peers is comfortable, routine and habit forming. In my experience, it is easy to form “bad” habits because many of these habits are comfortable and automatic. In order to make positive changes, the actions need to be conscious. It is difficult for many people who face time-constraints to make advantageous eating habits a priority. Even though most fast-food restaurants now offer healthier food alternatives, such as salads, people do not view that food as convenient. It is much easier to eat salty French fries while committing than to eat a salad.
Another Milio proposition discussed that people make choices based on their perceived personal or community resources (Milio, 1976). In my city of Pickerington, the population was recorded as 19,085 residents in 2013 and the city itself is 9.58 square miles (http://www.ci.pickerington.oh.us/Pages/Departments/Economic_Development/Demographics/). Pickerington hosts 19 fast food restaurants, with approximately 60 fast food restaurants in Fairfield County (https://visitfairfieldcountyoh.org/fastfood.php). This is compared to eight work-out facilities in Pickerington, and approximately 13 licensed workout facilities in the county, as per a Google web search. Most individuals crave expediency factors, whether related to food, shopping, commuting, or physical fitness. The Fairfield county statistics on cardiovascular disease and obesity can easily be correlated to the amount of fast food restaurants, deficiency of physical fitness facilities, and very likely, lack of community education on healthy lifestyle choices.
Ohio Department of Health. (2016). Fairfield County Community Health Status Assessment: Fairfield county community health status assessment: Examining the health of Fairfield county. Retrieved from http://www.myfdh.org/pdf/2016-Fairfield-County-Community-Health-Assessment.pdf
Pencak Murphy, M., Coke, L., Staffileno, B. A., Robinson, J. D., & Tillotson, R. (2015). Improving cardiovascular health of underserved populations in the community with life’s simple 7. Journal of the American Association of Nurse Practitioners, 27, 615-623. http://dx.doi.org/10.1002/2327-6924.12231
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