Launching Healthy People 2020 Objectives in AL Rural Community - Essay Sample

Introduction

This project seeks to launch and implement the Healthy People 2020 Health Objectives in four areas of health-related to fitness and wellness in a small rural community in Alabama. Working with the local Department of Social Services, the project leader has conducted a community health assessment to identify the areas that require improvement to enhance the overall wellbeing of the target community. The health issues identified are oral health, tobacco use, diabetes, and nutrition and weight status (Healthy People 2020, 2019). An analysis of existing health statistics for the four areas of health shows that the community needs more education, information, and resources in each of them. To address the concerns in each of the areas of health, it is necessary to raise resources and initiate programs focused on lowering the cost of care and improving the healthcare of the community in the four areas.

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The National Rural Health Association (1999) states that the supply of healthcare providers and primary care workers is very limited in rural areas (W.K. Kellogg Foundation, 2004). At the same time, it is difficult to deliver services targeting people with special health needs due to sparse population distribution. The more remote an area is the less coverage it is likely to have. Uninsured individuals and rural areas also have higher taxes of foregoing or postponing healthcare. Hence, the illnesses are likely to become more severe and cost more to treat. Accordingly, employers also spend more on insurance coverage for their workers in rural areas. As a result, they ask for higher co-payments and larger insurance premium contributions from the workers. Moreover, children in rural areas have higher chances of being uninsured than their counterparts in urban dwellings. However, since most families rely on employers' insurance coverage, they hardly enroll for services such as the State Children's Health Insurance Program (SCHIP).

Outreach programs for rural populations need to collaborate with existing aid programs such as Head Start, school lunch programs, child support programs, and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Community-based organizations can also collaborate with the state and faith-based institutions to increase public awareness of aid programs such as SCHIP and help with promoting enrollment. Through such collaborations, it is possible to reduce cultural barriers and stigmas that deter families from taking part in health assistance programs (W.K. Kellogg Foundation, 2004). For example, programs that target rural youth who are hard to reach need to collaborate with various action agencies in the community.

Unfortunately, most people in rural areas who have chronic health issues, and I need extensive healthcare to have economic difficulties such as hunger and poverty. Such problems worsen their illness and slow down healing. It is for this reason that the Institute of Healthcare Improvement (IHI) initiated the Triple Aim concept in 2008. The aim of the concept is to improve overall healthcare quality in the country, reduce per capita cost, enhance population health, and leverage patient experience. Similarly, the Affordable Care Act (ACA) of 2010 emphasized the delivery of care and payment of providers based on the value of care and not the volume. This is the idea that led to the rise of Accountable Care Organizations (ACOs), which require that both providers and care organizations vertical responsibility in delivering the requirements of the Triple Aim. Programs like ACOs motivate members to collaborate with agencies offering human services to strengthen and expand the conventional services, lower the cost of care, enhance population health, and enhance the patient experience.

In relation to the new standards of healthcare, programs ought to focus on delivering comprehensive population health care instead of only treating people who are sick. The programs have activities targeting the social health determinants and the overall wellness of communities. The United States government requires that all non-profit hospitals assess the health needs of their communities after every three years to facilitate the new care delivery approach. Hospitals in this rural community have utilized this provision to identify the healthcare areas that cost the highest and where there is the greatest need. Hospitals are expected to develop implementation strategies together with their communities to respond to identified social needs in coordination with human services ("Rural Health Information Hub," 2019). The strategies should also help to lower healthcare costs while enhancing population health at the same time.

When the Healthcare system collaborates and coordinates with the community and human services, it has created chances of tackling the social health determinants and avoiding overutilization of healthcare services ("Rural Health Information Hub," 2019). This helps reduce the burden of providing care and avoid reimbursement penalties related to value.

Oral Health

Oral Health issues affect poor and socially disadvantaged members of society more. Income, occupation, and education levels play into people who are more prone to oral diseases. They are present in a variety of races and age groups. I want to increase the number of children, adolescents, and adults that use the oral health care system. Ways that I want to implement in my program to help with the oral disease are oral care and promoting a well-balanced diet. Educating people on how they eat and drink can play a role in their oral conditions. Using protective equipment such as mouth guards can help to prevent tooth injuries. Tobacco use even smokeless type can play a large part in oral health. Another barrier is accessibility, which is related both to cost as well as having the services available near where they live. By providing education, locations, and dental care options, I believe we can improve the overall wellness of people and improve their quality of life.

The state of Alabama has ranked oral health as the number 12 health concern because of its impact on the health and wellbeing of its population. Dental visits for adults here are lower than many other places in the United States. Alabama has the firth worst percentage of adults visiting the dentist on an annual basis (Alabama Public Health, 2017). One of the barriers that we run into is unavailability of care and insurance coverage. There are nearly twice as many oral care locations in urban areas than in rural areas. Even with Medicaid available, less than half of children who can use it were seen by a dentist in the previous year, and that is in both rural and urban areas.

The Oral Health Branch was established to help with prevention and promoting availability and education for oral care throughout the state (Alabama Public Health, 2019). Their primary programs are oral health education, having water fluoridation, and establishing a dental screening program for both adults and children. Through these new initiatives, the patient to dentist ratio has improved from 2,201 patients to a dentist in 2014 to 2,139 to one dentist in 2016, increasing the availability of dentists to patients ("Jefferson County, AL," 2018). In 2012 only 42.1% of people visited the dentist compared to 43.3% in 2016. This rise shows that our programs are working.

Plan

I will develop a health improvement plan to guide the implementation of the oral health improvement plan in Alabama. We will work with the Department of Social Services and collaborate with many internal youth groups to help guide and implement the desired changes. The primary role of the Department of Social Services is to guide and monitor our compliance with the state and federal health policies. The local youth groups will take part in the actual implementation of the project, and I will coordinate and lead the entire project management.

The second step in the plan will be to prioritize issues in the project (Minnesota Department of Health, 2019). Our initial assessment indicated that one of the priority health concerns in this rural community is limited access to oral health services due to the high cost and uneven distribution of oral health workers. The other issues are tobacco use, lack of information or oral care and diet. The community members also do not use protective equipment such as tooth guards to prevent tooth injuries. Their issues will form the basis of our plan. However, the plan will not be limited to these issues alone since other concerns may arise in the course of the project.

We have specific goals for each of our identified priority issues. The action plan for increasing accessibility to oral health services includes increasing health insurance for more community members to enable them to afford dental services. The program will also organize with the state of Alabama Department of Health to have more community oral health workers in the rural community. For lack of information, the action plan is to educate community members on the relationship between a balanced diet and good oral health. We also hope to collaborate with external partners to purchase and distribute at least 1000 tooth guards, especially for youth who take part in field sports. The other action plan is to initiate a cessation program for tobacco addicts.

We will conduct a health status assessment three months after the program is rolled out to measure our progress. The community, health improvement assessment, will be based on the Management and Development for Health (MDH) and Public Health Accreditation Board (PHAB) requirements and standards (Minnesota Department of Health, 2019). It is necessary to use national standards to ensure that the program is accountable to all its stakeholders, improves credibility, and enhances the quality of work. The community oral health improvement plan will be adjusted according to the outcome of each assessment to ensure that it meets its goals.

Cost

Lately, the cost of providing health care has been rising rapidly in the United States. In the year 2009, the total expenditure on healthcare was $2.5 trillion. This includes the cost of direct public health services, purchase of medical supplies and equipment, prescription drugs, home nursing, home health care, physicians in dental services, and hospital care. Accounting for about 17% of our GDP, this one represents about $8,000 citizen. Ten years later, it is expected that the national expenditure on health has risen by at least 6% in 2019. Comparatively, the amount of money spent on dental services in the United States in 2009 was about $100 billion. This is almost 5% of the total healthcare spending (The National Academies Press, 2019). Despite the rising dental and medical spending, so far, medical expenditures have exceeded dental expenditures in growth.

However, the reported national expenditure on healthcare does not take into account the total amount spent on oral health. The estimates only represent expenditure on direct services that dentist offered in their normal work settings. It does not include the cost of public health initiatives such as public education campaigns and fluoridation of water. The estimates also exclude oral healthcare services provided during medical care. For example, at least 3 million cases of oral injuries cancers, and diabetes-related treated regular medical care every year.

On average, each dental patient spent slightly more than $600 in 2007. There are variations in expenditure based on insurance status, ethnicity, race, income, and age. The type of insurance also influenced the annual expenditure on dental services. For people with private dental insurance, the average annual cost was $660. Individuals using public dental insurance...