The only agreement surrounding the definition of population health is that almost everyone disagrees with each other’s definition.

RE: Discussion – Week 4

COLLAPSE

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            The only agreement surrounding the definition of population health is that almost everyone disagrees with each other’s definition.  The terms public health and population health are often interspersed, but many feel that they are two separate entities. Public health is seen as confining, and population health seems too broad. Whatever definition a person chooses to adopt, the five main determinants remain the same: access to healthcare, individual behavior, social environment, physical environment, and genetics (Kindig, Asada, Booske, 2008 para. 4).

            The determinant that causes the most inequality of health in my area is social environment. “Social determinant: A proposed or established causal factor in the social environment that affects health outcomes (e.g., income, education, occupation, class, social support)” (Kindig, 2007 p. 153). But I also feel that directly related to the social determinant is the health determinant. “Health care determinant: A proposed or established causal factor in health care that affects health outcomes (e.g., access, quantity, and quality of health care services)” (Kindig, 2007 p. 153).  I live in Collier County Florida. An area that is commonly known around the country to be one of the most prestigious and wealthy areas of the United States. It is a beach community and homes on the Gulf of Mexico, on average, are worth approximately 35 million dollars. However, this represents a very small portion of the entire county. The county also has a large community about 15 miles away where the entire population is Hispanic. “The latest census bureau data available indicate that in 2014, 53 percent of Collier County residents spoke a language other than English in the home. This is directly correlated with the growth of the Hispanic population” (Florida Health, p. 4). The vast difference in the social environment between these two areas is like comparing apples to oranges. The income, education, occupation and social support for the Hispanic community is virtually non-existent when compared to the beach community. The majority of the Hispanic population is brought by bus to the more affluent areas for construction, landscaping, and trash removal occupations.  The education system for the Hispanic area is one of the worst rated in the state and social support is non-existent. This community exists close to us but it is rarely spoken about. Because the community is of one race, the health-related disparities that Kindig (et al 2008) lists in the schematic, race/ethnicity, socioeconomic status, and geographical location, apply to almost the entire population.

As you can imagine, with such a poor social environment the health care determinants of access, quantity, and quality of health care are also almost non-existent. There are no health care facilities within the community, and many of the facilities within the more affluent area do not accept Medicaid or uninsured patients. “When accounting for race and ethnicity, Hispanics in Collier County are more likely to be uninsured than non-Hispanic whites and blacks. Health insurance coverage rates in Collier County and Florida are highly correlated with the education attainment and income level” (Florida Health, 2016 p. 6). With little income, education, and health care coverage, this community should be a top priority for lawmakers within our county. The other health determinants of individual behavior and genetics can be attributed to lack of health education. With few resources for any health care, the education of chronic diseases such as diabetes and how it can be prevented by lifestyle changes and its genetic component are also non-existent.

            One of the definitions of public health provided by Kindig defines it as “A conceptual framework for thinking about why some populations are healthier than others, as well as the policy development, research agenda, and resource allocation that flow from it” (Kindig, 2007).  I believe that Collier County is a true indication that not all resources of public health are distributed evenly and could be used as a research model of just how vast the differences often are. While the data is out there showing the injustice, little has been done to correct it.

References

Florida Health (2016). Collier County community health assessment. Retrieved from http://www.floridahealth.gov/provider-and-partner-resources/community-partnerships/floridamapp/state-and-community-reports/collier-county/_documents/CollierCHA.pdf.pdf

Kindig, D. A. (2007). Understanding population health terminology. The Milbank Quarterly85(1), 139–161. Retrieved from https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=17319809&site=ehost-live&scope=site

Kindig, D.A., Asada, Y, Booske, B. (2008). A population health framework for setting national and state health goals. Retrieved from https://jama-jamanetwork-com.ezp.waldenulibrary.org/article.aspx?articleid=181830

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