NR 717 Week 7 Discussion
Student Name
Chamberlain University
NR-717: Concepts in Population Health Outcomes & Health Policy
Prof. Name
Date
NR 717 Week 7 Discussion
Identify
Hello, respected officials of the Mississippi State Department of Health.
My name is Angelica Waller, MSN, BSN, RN, and I am currently pursuing my Doctor of Nursing Practice (DNP) in Healthcare Leadership at Chamberlain University. I have been a registered nurse for seven years, with extensive experience serving patients across different hospitals and clinics. Currently, I work as a nurse manager on a step-down intermediate care telemetry unit at Moore’s Park Memorial Hospital.
My nursing journey began as a floor nurse, where I frequently volunteered at a local clinic providing care for uninsured and underserved populations. Even in my managerial role today, I continue volunteering, coordinating with other healthcare professionals to set up mobile clinics and outreach initiatives. My professional and academic focus is to increase access to care, advocate for sustained funding for public health services, and reduce health disparities, especially in communities disproportionately impacted by hypertension and cardiovascular disease.
Situation
Citizens living in Jackson, Mississippi—particularly within the African American community—experience a disproportionately high prevalence of hypertension, which frequently progresses into chronic cardiac disease.
Why is this issue important?
Because factors such as low income, limited education, and reduced access to health coverage are strongly linked with disparities in hypertension and subsequent cardiac complications. Without intervention, these challenges place African Americans at higher risk of premature death and reduced quality of life.
This concern aligns with the mission of H. Res. 238 (IH), 114th Congress (2015), which aimed to raise awareness about health disparities in minority populations during National Minority Health Month. Populations affected include African Americans, Hispanic Americans, Native Hawaiians, Alaska Natives, American Indians, Asian Americans, and Pacific Islanders.
For Jackson, Mississippi, addressing hypertension and related cardiac complications is crucial. The lack of affordable health insurance, low health literacy, and structural inequities create barriers to care, making system-focused policies and sustainable community interventions an urgent need.
Background
The Mississippi State Department of Health plays a vital role in ensuring equity and addressing public health challenges, particularly given Mississippi ranks as the second-highest state for heart disease mortality in the United States (McCoy, 2024).
While the Affordable Care Act’s Medicaid expansion aimed to reduce uninsured rates, gaps remain. Adults without dependent children and with incomes below the poverty line still face no affordable health coverage options (Raphael & Rudowitz, 2024). This lack of coverage forces many individuals to delay or forgo care altogether.
As a nurse serving in marginalized communities, I have personally witnessed these inequities. Patients often avoid care due to fear of medical bills, lack of insurance, or distrust of the system. Their limited health literacy further compounds the problem, making it difficult for them to manage chronic illnesses such as hypertension.
Case Example: Jackie’s Story
A powerful example is a patient, here referred to as Jackie, a 52-year-old African American woman from Jackson. Jackie delayed medical treatment for symptoms such as leg swelling, cramps, nausea, and vomiting, fearing hospitalization and work absence. After eventually losing her job—and with it, her insurance—she was newly diagnosed with kidney and heart disease.
Unable to afford treatment, she skipped dialysis sessions due to cost and lack of transportation. Tragically, she was later found deceased at home from hypertension-related complications.
Jackie’s story highlights a painful reality: systemic barriers, unaffordable insurance, and insufficient community resources directly contribute to preventable deaths in African American communities.
Assessment
To address the health disparities within Jackson, MS, interventions must focus on both healthcare access and social determinants of health.
The table below summarizes critical issues and potential interventions:
| Issue Identified | Impact on Community | Proposed Intervention |
|---|---|---|
| Lack of affordable insurance | Delayed or forgone care; worsening chronic illness | Expand Medicaid coverage; introduce subsidies for adults without dependents |
| Poor health literacy | Mismanagement of chronic conditions | Implement community-based health education programs |
| Economic instability | Limited access to medications and healthy lifestyle | Job training, employment opportunities, and inclusion of community health workers |
| Structural racism in healthcare | Disparities in diagnosis and treatment | Mandatory provider training on implicit bias and cultural competency |
| Limited preventive care access | Higher rates of late-stage disease | Routine community screenings for hypertension and cardiovascular risk |
Research indicates that community health workers integrated into care teams significantly improve hypertension control and reduce cardiovascular risks (Williams & Cooper, 2019). Addressing employment opportunities, health literacy, and insurance coverage simultaneously creates a foundation for long-term improvements.
Recommendations
The Mississippi State Department of Health is urged to implement policies and allocate resources that will:
- Expand access to affordable health insurance, particularly for adults without dependents.
- Invest in social needs care services that engage community members in healthcare decisions.
- Strengthen collaboration between social service providers and healthcare teams for holistic patient support.
- Enhance preventive healthcare services, including free or low-cost hypertension and cardiac screenings.
- Integrate community health workers into care models to improve outcomes in underserved areas (Williams & Cooper, 2019).
- Address racism in healthcare delivery through provider training and equity-focused policies.
- Support Medicaid advocacy and policy reform to ensure broader access and affordability.
Request
Thank you for considering this vital initiative. I respectfully request the opportunity to collaborate with the Mississippi State Department of Health to:
- Develop and implement educational programs.
- Establish mobile clinics and community screening sites.
- Launch a 12-month pilot intervention project, followed by surveys and assessments to measure its effectiveness.
Stakeholders, providers, and policymakers must remain committed advocates for health equity, ensuring African Americans in Jackson, MS, receive the care and dignity they deserve.
Salutation
Thank you once again for your time and commitment to improving health outcomes for disadvantaged populations. Please feel free to reach out to me for further discussion or collaboration.
Sincerely,
References
Chelak, K., & Chakole, S. (2023). The role of social determinants of health in promoting health equality: A narrative review. Cureus. https://doi.org/10.7759/cureus.33425
Ercia, A. (2021). The impact of the Affordable Care Act on patient coverage and access to care: Perspectives from FQHC administrators in Arizona, California and Texas. BMC Health Services Research, 21(1). https://doi.org/10.1186/s12913-021-06961-9
Erlangga, D., Suhreke, M., Ali, S., & Bloor, K. (2019). The impact of public health insurance on health care utilization, financial protection, and health status in low- and middle-income countries: A systematic review. PLOS One, 14(8), e0219731. https://doi.org/10.1371/journal.pone.0219731
Jurns, C. (2019). Using SBAR to communicate with policymakers. Online Journal of Issues in Nursing, 24(1), 13. https://doi.org/10.3912/OJIN.Vol24No01PPT47
McCoy, M. (2024, February 22). Mississippi has the 2nd-highest heart disease mortality rate in the US. WJTV 12 News. https://www.wjtv.com/living-local/focused-on-health/mississippi-has-2nd-highest-heartdisease-mortality-rate-in-us/
NR 717 Week 7 Discussion
Raphael, J., & Rudowitz, R. (2024, March 12). A closer look at Medicaid expansion efforts in Mississippi. KFF. https://www.kff.org/policy-watch/a-closer-look-at-medicaidexpansion-efforts-in-mississippi/
Williams, D. R., & Cooper, L. A. (2019). Reducing racial inequities in health: Using what we already know to take action. International Journal of Environmental Research and Public Health, 16(4), 606. https://doi.org/10.3390/ijerph16040606