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NR 717 Week 6 Discussion

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Chamberlain University

NR-717: Concepts in Population Health Outcomes & Health Policy

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NR 717 Week 6 Discussion

Focus on Health Disparities in African American Communities

Health disparities continue to disproportionately affect African American populations across the United States, with particularly concerning trends in areas such as Jackson, Mississippi. One major health issue is the high prevalence of hypertension, which contributes significantly to cardiovascular disease and premature mortality. Governmental efforts, such as House Resolution 238 of the 114th Congress (introduced on April 30, 2015), recognized the urgent need to address minority health inequalities. This resolution supported the goals of National Minority Health Month, focusing attention on inequities affecting African Americans, American Indians, Alaska Natives, Asian Americans, Hispanic Americans, and Native Hawaiians or Pacific Islanders.

Despite these initiatives, challenges persist. African Americans continue to carry a heavier burden of chronic disease due to multiple intersecting factors, including systemic racism, poverty, and limited access to quality healthcare. A higher uninsured rate among this population further limits opportunities for timely treatment and preventive services, worsening the cycle of poor health outcomes (Artiga et al., 2024).

Define the Problem

Question: What is the primary problem being addressed?

Although progress has been made in minority health policy, African Americans still face significant disparities in access to care and disease outcomes. High rates of uninsured status, financial hardship, and historical inequities have created structural barriers that perpetuate poor health. Hypertension is particularly concerning because it is both common and highly preventable, yet African Americans experience higher prevalence and greater risk of complications such as stroke and heart disease. This issue highlights the intersection of social determinants and health inequities that require systemic solutions.

Assemble Evidence

Question: What evidence supports this problem?

Healthy People 2030 reports that hypertension prevalence among African American adults is markedly higher compared to other groups. The initiative set a target of reducing adult hypertension from a baseline of 45.0% to 41.9%, emphasizing the urgent need for interventions (Healthy People 2030, n.d.).

A systematic review by Del Pino et al. (2019) further revealed that health disparities among African-descendant populations in the Americas stem from historical and structural inequities. Their research underscored how socioeconomic conditions, systemic racism, and environmental factors collectively drive poorer outcomes.

Table 1

Determinants of Health Inequities among African Americans

DeterminantImpact on Health
Poor living conditionsHigher risk of chronic disease due to limited access to safe housing and nutrition
PovertyRestricted access to preventive and primary care
Environmental exposuresIncreased disease burden due to pollutants and toxins in disadvantaged areas
Systemic discriminationCreates mistrust in healthcare and reduces use of preventive services
Community disadvantagesLimited access to healthcare facilities, wellness programs, and health education

This evidence demonstrates that African American health disparities are not only biological but also deeply rooted in systemic and structural inequities.

Develop Alternatives

Question: What alternatives can address these disparities?

Addressing disparities requires solutions that are community-centered, culturally appropriate, and sustainable. Effective alternatives include:

  • Community Health Workers (CHWs): CHWs can strengthen connections between underserved populations and healthcare providers by offering culturally sensitive support, education, and outreach.

  • Cultural Competency Training: Training healthcare professionals to recognize and reduce implicit bias fosters better communication and equitable care delivery.

  • Community-Based Programs: Collaborations among hospitals, churches, and community organizations can improve access to screenings, education, and preventive services.

  • Health Education Initiatives: Expanding programs that provide family-centered education on chronic disease prevention enhances self-management and reduces complications.

Select Criteria to Evaluate Alternatives

Question: How can we evaluate the effectiveness of these alternatives?

Table 2

Evaluation Criteria for Interventions

CriteriaDescription
EfficiencyMeasures how effectively resources reach target populations
Cost-effectivenessAssesses whether health gains outweigh program costs
Population health benefitsEvaluates reduction in hypertension rates and improvement in quality of life
Equity in healthcareDetermines whether interventions reduce disparities in care access

By applying these criteria, programs can be assessed for both short-term outcomes (e.g., improved access) and long-term sustainability.

Project Outcomes

Question: What are the expected outcomes of the selected intervention?

The anticipated outcomes include:

  • Cost-effectiveness: CHW programs reduce costs compared to physician-led initiatives while providing substantial benefits at the community level.

  • Community feedback mechanisms: Affordable tools such as surveys and focus groups can track effectiveness and identify barriers.

  • Improved health equity: Programs expanding insurance access and implementing community-based strategies are expected to reduce preventable hospitalizations linked to hypertension.

Analyze Trade-offs

Question: What trade-offs must be considered?

While CHW-led interventions are affordable and community-centered, they may lack advanced medical expertise. Conversely, expanding insurance coverage enhances access but requires significant funding commitments. Decision-makers must balance affordability, feasibility, and long-term population health benefits.

Make Decisions

Question: What decisions are recommended to address the problem?

Key recommendations include:

  • Expanding insurance access through Medicaid and other programs to remove financial barriers.

  • Strengthening community partnerships by involving faith-based and local organizations in culturally appropriate health interventions.

  • Investing in CHWs and provider training to promote preventive care, trust-building, and equity in treatment.

Communicate Results

Question: How should the results be communicated?

Results should be disseminated in ways that are accessible and culturally relevant, including community forums, faith-based outreach, and digital platforms. Research indicates that community-based participatory approaches, mobile health tools, and faith-based interventions significantly enhance cardiovascular health outcomes in African American populations (Buis et al., 2019; Haynes et al., 2022).

References

Artiga, S., Hill, L., & Presiado, M. (2024, February 22). How present-day health disparities for Black people are linked to past policies and events. KFFhttps://www.kff.org/racial-equity-and-health-policy/issue-brief/how-present-day-health-disparities-for-black-people-are-linked-to-past-policies-and-events/

Buis, L. R., Dawood, K., Kadri, R., Dawood, R., Richardson, C. R., Djurić, Z., Sen, A., Plegue, M. A., Hutton, D., Brody, A., McNaughton, C. D., Brook, R. D., & Levy, P. D. (2019). Improving blood pressure among African Americans with hypertension using a mobile health approach (the MI-BP App): Protocol for a randomized controlled trial. JMIR Research Protocols, 8(1), e12601. https://doi.org/10.2196/12601

Del Pino, S., Sánchez-Montoya, S. B., Guzmán, J. M., Mújica, Ó. J., Gómez‐Salgado, J., & Ruíz-Frutos, C. (2019). Health inequalities amongst people of African descent in the Americas, 2005–2017: A systematic review of the literature. International Journal of Environmental Research and Public Health, 16(18), 3302. https://doi.org/10.3390/ijerph16183302

NR 717 Week 6 Discussion

Haynes, N., Kaur, A., Swain, J. D., Joseph, J. J., & Brewer, L. C. (2022). Community-based participatory research to improve cardiovascular health among U.S. racial and ethnic minority groups. Current Epidemiology Reports, 9(3), 212–221. https://doi.org/10.1007/s40471-022-00298-5

Healthy People 2030. (n.d.). Health equity in Healthy People 2030. U.S. Department of Health and Human Serviceshttps://health.gov/healthypeople/priority-areas/health-equity-healthy-people-2030

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