NR 717 Week 6 Discussion
Student Name
Chamberlain University
NR-717: Concepts in Population Health Outcomes & Health Policy
Prof. Name
Date
NR 717 Week 6 Discussion
Focus on Health Disparities in African American Communities
Health disparities continue to disproportionately affect African American communities, particularly in regions such as Jackson, Mississippi. One critical area of concern is the high prevalence of hypertension, which often progresses into heart disease. These disparities have been formally recognized in government initiatives, such as the House Resolution 238 of the 114th Congress (introduced on April 30, 2015). This resolution supported the goals of National Minority Health Month by highlighting inequities experienced by minority groups including African Americans, American Indians, Alaska Natives, Asian Americans, Hispanic Americans, and Native Hawaiians or other Pacific Islanders.
Although the resolution emphasized the need for awareness and action, significant challenges remain unresolved. African Americans continue to face disproportionate health burdens, influenced not only by biology but also by social determinants of health such as systemic racism, poverty, and unequal access to care. The persistence of higher uninsured rates exacerbates barriers to timely treatment and preventive care (Artiga et al., 2024).
Define the Problem
Question: What is the primary problem being addressed?
Even though national and local initiatives have made progress in minority health, health disparities remain highly prevalent. African Americans continue to face higher rates of uninsured status, financial barriers, and limited access to culturally competent care. Historical and systemic inequities have created a cycle of disadvantage that perpetuates poor outcomes. For instance, hypertension among African Americans remains one of the most significant contributors to increased cardiovascular morbidity and mortality in these populations.
Assemble Evidence
Question: What evidence supports this problem?
Data from Healthy People 2030 (n.d.) indicates that the prevalence of hypertension in African American adults remains disproportionately high. The program set a goal of reducing adult hypertension from 45.0% (baseline) to 41.9% (target), underscoring the urgency of intervention.
A systematic review by Del Pino et al. (2019) further emphasized the relationship between ethnicity, social conditions, and health outcomes. Their study asked: What public health evidence exists about health inequalities related to the (historical, social, and cultural) ethnic conditions of people of African descent in the Americas, compared to other population groups? Findings showed that African Americans and Afro-descendant groups across the Americas experience inequalities due to:
| Determinant | Impact on Health |
|---|---|
| Poor living conditions | Increased risk of chronic diseases due to inadequate housing and nutrition |
| Poverty | Limited access to preventive and primary healthcare |
| Environmental exposures | Exposure to pollutants and chemicals contributes to disease burden |
| Systemic discrimination | Perpetuates mistrust in healthcare and reduces engagement in preventive practices |
| Community disadvantages | Decreased access to quality healthcare facilities and health-promoting resources |
This evidence highlights how structural inequities intersect to worsen health disparities among African Americans.
Develop Alternatives
Question: What alternatives can address these disparities?
A sustainable solution requires a collaborative, community-based approach. Some alternatives include:
- Community Health Workers (CHWs): Recruiting and training CHWs to bridge gaps in healthcare access, provide education, and promote trust within marginalized populations.
- Cultural Competency Training: Educating healthcare providers on culturally sensitive practices to improve communication and reduce bias in treatment.
- Community-Based Programs: Partnerships between hospitals, faith-based organizations, and local agencies to offer screenings, education, and preventive services.
- Health Education Initiatives: Expanding outreach beyond individual patients to include families and communities, empowering them with knowledge about disease prevention and management.
Select Criteria to Evaluate Alternatives
Question: How can we evaluate the effectiveness of these alternatives?
The following criteria should be considered when evaluating interventions:
| Criteria | Description |
|---|---|
| Efficiency | Are resources being used effectively to reach the target population? |
| Cost-effectiveness | Do the benefits of improved health outcomes outweigh the program costs? |
| Population health benefits | Does the program reduce hypertension rates and improve overall quality of life? |
| Equity in healthcare | Does it reduce disparities and ensure fair access to care? |
By applying these criteria, decision-makers can ensure that interventions are impactful, sustainable, and culturally appropriate.
Project Outcomes
Question: What are the expected outcomes of the selected intervention?
- Cost-effectiveness: Using CHWs is less costly than physician-led interventions but provides significant community benefit.
- Community feedback: Surveys and interviews are affordable tools that help evaluate program impact and barriers.
- Improved health equity: Insurance expansion and community-based programs aim to reduce barriers to care, ultimately decreasing hypertension-related hospitalizations.
Analyze Trade-offs
Question: What trade-offs must be considered?
Decision-makers must weigh population health benefits against program costs. While CHW programs are cost-effective, they may lack the advanced expertise of physicians. Expanding insurance coverage can improve access but requires significant state-level funding. Thus, a balance between affordability and comprehensive care is necessary.
Make Decisions
Question: What decisions are recommended to address the problem?
- Expand medical insurance access: Insurance coverage has shown success in improving healthcare utilization, as seen in Medicaid expansion programs.
- Strengthen community partnerships: Stakeholders must collaborate to implement supportive, culturally tailored health programs.
- Invest in CHWs and provider training: These initiatives can build trust, improve patient engagement, and enhance preventive care efforts.
Communicate Results
Question: How should the results be communicated?
Findings should be shared through community forums, faith-based networks, and digital platforms, ensuring accessibility to all members. Studies support that community-based participatory approaches, including mobile health tools and faith-based initiatives, can significantly improve cardiovascular health among minority groups (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. KFF. https://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
NR 717 Week 6 Discussion
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
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 Services. https://health.gov/healthypeople/priority-areas/health-equity-healthy-people-2030