I found these articles to be incredibly
interesting to read and they both got me thinking about the flaws of our health
care system and how we can strive to make it better equipped to help people,
which is its intended purpose. The article Funding
healthy society helps cure health care makes me wonder how many cases that
are brought into hospitals and clinics could be prevented by simple
interventions such as eating healthier, or eating enough in this specific
child’s case. It reminds us that we must focus on the root of the problem
instead of just focusing on the problem itself. Some physicians and medical
professionals have developed tunnel vision when it comes to the treatment of
their patients. Instead of focusing on the patient as a whole they focus solely
on the symptoms. As health care providers it is important to remember that
there is a face that goes along with these symptoms. The patient’s case is a
multifaceted system and in order to provide the best care we must delve into
all possible causes of the issue, which may not be exclusively medical.
The second
article also discussed problems with health care and associated programs
attempting to make a difference. Health Leads is a program of trained college
students who provide patients with connections to necessary resources such as
food banks. According to the article they serve roughly 9,300 patients and
families and the program is quickly gaining recognition and momentum. I think
this is an awesome project for college students and a great way for us to help
make a difference in our world. Another program discussed in the article was
Medical-Legal partnership for children, which brings lawyers into the hospital
setting to assist patients with situations where physicians are unable.
Examples include unsafe living conditions or domestic violence. This is a
beneficial program because it allows people to receive the most appropriate
care and assistance. For example if a physician is consistently seeing a
patient with problems associated with domestic violence the physician can help
to cure the patient of their symptoms, but we are not solving the ultimate
issue at hand. In this case a lawyer would be able to fix the problem at the source
instead of just treating the associated symptoms.
Poverty has a
huge effect on the health of an individual or a family. If people are unable to
afford enough food to meet adequate nutritional requirements they risk becoming
malnourished. According to the U.S. Nation Library of Medicine malnutrition can
cause mental and physical disabilities, illness and death (2011). A non-medical
problem associated with hunger and lack of food is decreased focus and
attention. Children who go to school hungry have a harder time focusing on the
task at hand than a child who ate a nutritious breakfast. Several schools have
created programs to assist children in this situation by offering free or
reduced-cost meals. Adults who go to work hungry may face the same issues. It
is hard to be focused and alert when all you can think about is your growling
stomach. It is obvious that lack of focus will lead to poor performance in
schools and at the work place. Without proper education it is hard to get a
well paying job, and poor performance at work may lead to termination. Both of
these situations propel the line of poverty that already exists for these individuals.
Families and
individuals living in poverty are often times not living at an optimum health
status and this can hurt the community as a whole. Exposure to unsafe living
conditions, inadequate nutrition and a variety of stressors takes a toll on the
health status of people. With limited money and resources they may not be able
to seek adequate health care and therefore will remain ill. Disease and illness
can travel quickly in run down communities with poor sanitation and limited
health precautions. Community-wide pneumonia, TB and influenza are all possible
outcomes. Another way that poverty affects a community is an increase in crime.
According to Blake Taylor from economics.fundametalfinance.com there are several
reasons why areas of poverty experience more crime. The stress of poverty may
lead people to participate in crime and other violent acts. Also, people in
poverty may see stealing as the only way to obtain material goods (2006). Poverty
does not only affect individuals and families, it is a community wide issue
that creates a multitude of problems.
Specific
interventions that could be done to address and help alleviate the problems
associated with poverty are outreach and health teaching. Outreach “locates
populations of interest at risk and provides information about the nature of
the concern, what can be done about it and how services can be obtained” (Nies
& McEwen, 2011, p. 15). This could be achieved by informing people of resources
in their community that offer needed assistance. Examples include food banks,
free clinics, free immunization drives, family planning clinics and additional
resources. Many people are unaware that these types of programs exist and it is
our job as nurses to inform our patients of these opportunities. Another
intervention would be health teaching, which “communicates facts, ideas, and
skills that change knowledge, attitudes, values, beliefs, behaviors, and
practices of the individuals, families, systems, and or/communities” (Nies
& McEwen, 2011, p. 15). As nurses we establish a trusting relationship with
our patients and we have the opportunity to educate them about ways to live a
healthier life. We can focus on the benefits of healthy eating, exercise and
techniques to cope with stress to promote the health of our patients. Leading a
healthy lifestyle may prevent costly and time-consuming visits to health
facilities, which may be of limited access to those living in poverty. Eating a
well balanced diet, getting enough exercise and maintaining an appropriate body
weight helps to greatly reduce the risk of many diseases and health
complications. By teaching patients prophylactic steps to avoid health
complications we can attack the problem at the source and save them a lot of
time, money and stress.
References
Nies, M.A. &
McEwen, M. (2011). Community/public health nursing: Promotion the health of
populations (5th ed.)
St. Louis, MO: Saunders/Elsevier.
Taylor, B. (2006). Poverty and crime. Retrieved from
http://economics.fundamentalfinance.com/povertycrime.php
Zieve, D., & Eltz, D., R. (2011). Malnutrition. Retrieved
from
http://www.nlm.nih.gov/medlineplus/ency/article/000404.htm
Hannah, I really enjoyed your blog, as well as, your point of views on the topic of vulnerable populations. I really enjoyed your comment on “tunnel vision” of treating individuals- great analogy! I think we tend to forget that sometimes that these people of lives, families, and careers that are just as important and should be consider when establishing patient outcomes.
ReplyDeleteI really found intriguing the topic of hunger and how it affects our daily living, especially in children. Recently I just went to a speaker who manages the Community Table in Eau Claire, where it provides 1 meal a day for those who cannot afford it otherwise. I and learned a ton of information that was shocking and inspiring to hear. From this presentation it was reported the 1:5 children go to bed hungry in the Eau Claire. If in a class room size of say 20-some students this would be about 5 kids. However, not only is this problem then effecting these 5 children who go to school hungry, it then effects the other children of that classroom. As you had mentioned hunger interferes with their concentration, focus, and essentially their education. We can see from economics resource that you had posted, poverty levels can also lead to behavior issues (Taylor, 2006). Many times these children get labeled as the “naughty kids”. With the teachers then having to interrupt class to focus on these children, are the other children of the class getting the proper and fullest education possible? I’m sure the schools, and more importantly parents, would be concerned if children were not performing well, and may even consider private education. When the speaker had mentioned this, it just put everything into perspective about the severity of the issue of poverty! It is refreshing that schools have then taken initiative in breakfast programs, which public health nurses could initiate this change in other schools.
Again outreach and providing information is a necessity for this situation. We can do so much to help these people if we show them the available resources for their needs greatest duties and life changing interventions as a nurse.
Taylor, B. (2006). Poverty and crime. Retrieved from http://economics.fundamentalfinance.com/povertycrime.php
Hannah,
ReplyDeleteI was very interested in the direction you took with increased crime rates. This topic interests me because I have always wondering the cascading affects of situations such as poverty. In the article, Growing Up in Poor Neighborhoods, they discuss the idea of how children living in poor communities find it harder to escape poverty. Reducing socioeconomic segregation will improve a child’s chance of escaping poverty as they grow and build their life. They also discuss the situation of living next to disadvantaged neighbors because if the neighbors are committing crimes or drinking too much alcohol, it is likely that the children will follow. On the other hand, living next to advantaged neighbors is not beneficial either because it promotes resentment. This is why many social scientists believe that eliminating socioeconomic segregation will benefit the entire community.
I also agree with the aspect of how people living in poverty believe that committing crimes and stealing is the only way that they will obtain physical goods. There is a lot of stress that comes with not being able to afford food or shelter, and people tend to do things that they normally wouldn’t when life gets tough. I personally believe that, as a whole, the focus needs to be on preventing these situations by providing education on how to get jobs or how to manage money for example. There are many ways to approach this situation by thinking upstream instead of waiting for problems to occur and then trying to fix them after the fact.
Mayer, S. E., & Jencks, C. (1998). Growing up in poor neighborhoods. 243(4897), Retrieved from http://cpmcnet.columbia.edu/dept/healthandsociety/events/ms/year4/pdf/sd_Mayer, S.E. and Jencks, C.pdf
Hannah,
ReplyDeleteI also found these articles to be very interesting and agree that many interventions could prevent many hospitalizations. I also think that finding the root of the problem is essential. When you mentioned that some physicians and medical professionals have tunnel vision I completely agree. I have noticed that some doctors do solely concentrate on the immediate problem and they don’t focus on the underlying problem. They also think very technically.
I think the programs that were mentioned in the second article are very beneficial. Bringing lawyers into the mix is helpful in the cases involving domestic violence or unsafe living conditions.
I found it interesting that poverty can cause so many things such as mental and physical disabilities. It makes sense that children who go to school hungry have a harder time concentrating and focusing on the task at hand because a person is unable to think clear when they are hungry, especially if they haven’t had a nutritious breakfast. The programs in school has reduced these problems greatly in my opinion by providing cheaper meals to the poorer children whose parents can’t afford the regular priced meals or groceries to send lunches with their children to school. A well-fed child has a better chance of being successful later in life.
I like that you brought the public health wheel into this. Outreach to these populations and teaching them about healthy living is essential. Nurses can play important roles in both of these and can be very influential in the vulnerable peoples lives.
“We must focus on the root of the problem instead of just the problem itself”
ReplyDeleteI think this statement sums up the problems addressed in both of these articles. As we learned earlier in the semester, upstream thinking focuses on preventing the cause of the problem whereas downstream thinking deals with correcting the aftermath of a problem. It seems that our current medical system has a very downstream way of thinking, doctors are focusing on treating symptoms instead of getting to the root of the cause. This is a big problem because it is costing the healthcare system and, more importantly, our patients a lot more money and stress than need be. I really appreciate this topic being brought up because I feel it is the root of the health care system dysfunction we are currently experiencing. So instead of the mainstays of our treatments being medications it would be amazing to see what kind of changes we could make by teaching and “prescribing” healthy practices such as eating a well-balanced diet, exercising, and keeping a clean environment.
I agree with you that we need to focus on outreach to those in poverty. Helping to provide the basic necessities such as nutrition and safe/clean living conditions will decrease the incidences mental and physical disabilities, illness, decreased focus and attention, death, and rates of infectious diseases. Also, education is the single most effective way to empower people with limited resources. Education will give them the knowledge to make the best decisions with the resources that they have.
Hannah, I think you summed up these two articles very well. Overall, we are seeing that physicians and other health care workers have this “tunnel vision” as you said. This is unfair to the patient and is often a waste of medical resources and time. I think it is essential for health care workers to understand this and take a few extra minutes during a visit to truly get to know the patient and ask questions that may help find a simpler solution. Nurses also can have a large impact by continuing to advocate for their patient and help re-evaluate the treatment plan. I myself have experienced this “tunnel vision” effect first hand. It is not fun when you feel like you were not being listened to and that “nobody understands.” I’m sure this is frustrating for other people as well, especially those with little to no insurance. Co-pays may be charged for each visit, and if the first visit was not adequate enough, they may have to come back in again. From the health care side, resources are being wasted and time isn't being managed very well in these situations.
ReplyDeletePoverty itself is something we probably cannot completely get rid of, but what we can do is continue to outreach and promote upstream thinking. The amount of suffering that those in poverty go through physically and mentally puts them at a greater risk for infections, illness, and even death. Health Lead and the Medical-Legal partnership are great resources that we as students can get involved in to help satisfy some of those basic needs so that they may succeed in other areas of life. As Maslow’s hierarchy promotes, if the basic needs aren’t met, the person is not going to be worried about going to school or other issues higher on the pyramid.
Hannah,
ReplyDeleteI enjoyed reading your post about vulnerable populations. It’s easy to think about third world countries having problems feeding their people – but it is hard to believe that in a country of our status that children go hungry on a daily basis. I remember my mother telling me a few years back that a friend of the family was Santa Claus in their medium sized community. It astonished me to her from her that 50% of the children asked Santa to bring them food for Christmas.
As you mentioned, a lack of food can cause decreased focus and attention. From experience, I know that if I am hungry during lecture I have a hard time focusing and paying attention. Many of these children go home to empty cupboards and are expected to do homework on material they do not understand. I believe that we need to focus on the root of the problem instead of putting a Band-Aid on the problem. After all, why are these children hungry? Schools do an excellent job providing free and reduced meals to children who don’t have the resources at home. There will always be a demand for these immediate services, a downstream approach, but have you ever stopped to think why do these families need free or reduced lunches? How can we apply an upstream approach instead of a downstream approach?
The article “How Far Upstream Can We Go?” describes five layers of intervention: individual action, collective action, systemic causes, changing ideas, and evolving culture (Senehi, 2012). The community becomes more effective when shifting from an individualized action to a more institutionalized collective action. For example, a soup kitchen or school lunch program provides more of an outreach than someone giving spare change to someone on the street. However, moving up the ladder becomes more of a stretch of imagination. Senehi states that “we have to shift from trying to help a homeless person on the street in front of us, to wondering why people are homeless in the first place and looking at how we might prevent those problems at a systematic level, to questioning the underlying belief systems that foster social inequality” (2012).
The same type of thinking can be applied to the children. Why are the families struggling? Do they need education or a job? How can we get them to a point where they doing need assistance?
Reference
Senehi, Gerard. (2012, May 23). How far upstream can we go? Retrieved from http://www.inspiredlegacies.org/blog/?tag=upstream