Epidemiology
The healthy people 2020-initiative focuses on promoting people’s health and accomplishing previous health initiatives created in the past. The initiative is a result of collaborative and multilayered inputs from different organizations and individuals interested in promoting people’s health. Some of the objectives for improving people’s health, that are associated with this initiative include promoting access to quality healthcare services, reduction of disease rates, and improving the quality of care for different health conditions. This essay will discuss three community-based public health problems affecting the Los Angeles population, which include access to healthcare services, nutrition and weight status, injury and violence prevention. The zip code for Los Angeles used in this essay will be 90023.
Health Problems
Access to health care services entails the availability to healthcare facilities near people, the ability to access health insurance, ability to cater for one’s healthcare costs. Access to healthcare services is essential for preventing diseases and managing them, reducing mortality rates, and achieving the healthy people 2020 goals of providing quality healthcare services to all Americans. Problems affecting access to healthcare services in Los Angeles relates to the provision of timely services, insurance coverage, and availability of important health services. The major challenge promoting poor access to healthcare services especially among Latinos residing in the East Los Angeles regions is lack of health insurance and financial stability to cater for family health needs. A study that examined access to healthcare services in this population showed that individuals who had healthcare insurance in East Los Angeles had a 77 percent lower odd of complaining about poor access to healthcare services and were likely to utilize these services (Alcala, et al., 2016). Those who were not insured were less likely to utilize emergency department services.
Lack of culturally competent care and high costs of healthcare services has also influenced the utilization of these services in Los Angeles. Los Angeles has more than ten million residents and is considered one of the most culturally diverse counties in the country (Berger, 2018). Considering the increased population of Latinos in Eastern Los Angeles, healthcare providers in these areas need to be culturally competent and understand the needs of the population. This East Los Angeles region is also characterized by a high prevalence of Spanish-only households, which is significant in determining where they seek their healthcare services (Alcala, et al., 2016). Although not all members of these communities speak Spanish, the few who come from the Spanish-based homes prefer obtaining healthcare services from people facilities that can effectively communicate with them.
The issue of injury and violence is common in society. In America, unintentional and violent injuries have been classified among the top fifteen causes of death in the country. Studies show that crime rates in Los Angeles increased between 2015 and 2016 as robberies increased by 13%, crimes related to property increased by 4%, and cases of assaults went up by 10 percent. Evidence about the increased rates of crime was also obtained from the Los Angeles Police Department reports on homicide cases. Homicide cases were reported to have increased by a third with 290 people being killed in 2016. The region is also associated with a high immigrant population, which is commonly associated with an increased crime rate due to social disorganization and poverty. Hate crimes are also common in Los Angeles due to racial diversity and high poverty levels. Aside from that, LGBT individuals living in the city have also been direct victims of hate crime (Berger, 2018). These among other factors that promote crime contribute to injuries and violence in the county.
The issue of nutrition and weight status is a common problem among Americans. The high population rate in Los Angeles is also characterized by a higher rate of childhood and adulthood obesity. The high obesity rates are associated with a poor dietary intake that entails consumption of fast foods which are rich in simple carbohydrates and unhealthy fats (Sturm & Hattori, 2016). Inadequate physical activity has also been associated with the risk of obesity.
How The Problems were Identified
The problem of access to healthcare services in these regions was identified through existing barriers such as high healthcare costs, inadequate insurance coverage or lack of insurance among some of the individuals, poor quality of services offered in community clinics due to language barrier, incompetence, and other challenges. Aside from that, the morbidity and mortality rates in Los Angeles were also suggestive of the poor access to healthcare services among its inhabitants. Cases such as drug overdose, cancer, coronary heart disease, chronic obstructive pulmonary disease, and stroke have been the leading causes of death in Los Angeles (County of Los Angeles, 2013). Aside from these cases, the progression of diseases is common among individuals due to lack of proper healthcare services.
The problem of injuries and violence in Los Angeles is associated with high crime rates, the existence of poverty-stricken neighborhoods, distance between people’s working areas and their homes, street subdivision dynamics. Overpopulation in Los Angeles is a common influence of the high crime rates in the county. The high crime rates in Los Angeles were identified through evidence obtained from survey results and research articles. Connecting factors such as overpopulation, poverty, LGBT victimization, and racial discrimination, which are common in Los Angeles, provides an explanation for the high rates of injuries and violence in the county (Berger, 2018). Although anyone in the county can be a victim of crime, these factors predispose Los Angeles residents to crime. The problem of obesity was identified in Los Angeles through surveys conducted on the rates of overweight and obesity individuals in the county. The rates of adult obesity have risen 9.3 percent from 2000 to 2016 among adults (Healy, 2017). The obesity growth rates can be viewed from CDC growth charts.
Plan of Action
According to the Healthy 2020 people initiative, some of the plans that have been put in place to improve access to healthcare services include provision if free medical services to homeless people, conducting outreaches to encourage people to utilize community healthcare facilities, and encouraging people to obtain health insurance coverage (Health Quality Ontario, 2016). Other aspects that can be implemented to improve healthcare services include supporting healthcare community programs and reducing disparities in health for people with chronic illnesses and disabilities.
During the 2015 National Center for Health Statistics, about 9 percent of the people interviewed did not have health insurance, with 10.6% of that population comprising of people under 65 years. The provision of evidence-based preventive services has been proven by CDC to be cost-saving and promote the reduction of deaths and disabilities. Promoting the quality of care offered to patients by reducing waiting time in emergency departments, delayed care provision, and promoting patient satisfaction through cultural competence could promote better access to healthcare services (Centers for Disease Control and Prevention, 2016). Aside from that, educating the community about the importance of seeking healthcare services before the development of complication related to diseases can also promote their interest in accessing these services.
The Healthy People 2020 formulated a goal aimed at preventing violent cases and unintentional injuries. Attainment of this goal is focused on preventing premature death, disabilities emerging from violence, promoting mental health to limit cases of violence associated with mental illnesses. The efforts to prevent these injuries as recommended by the initiative are focused on environmental modification, involving law enforcers in arresting and punishing offenders, provision of education and promotion of behavior change. Other efforts recommended by the initiative include changing social norms that promote the acceptability of violence and hate crimes, improving people’s competencies in conflict resolution, parenting, and communication. Promotion of these skills can reduce cases of hate crime in Los Angeles (Injury and Violence Prevention, 2019). The initiative aims to foster safe relationships and provide families and children safe social environments. Implementation of policies to address the economic and social circumstances that commonly give rise to violent cases.
In terms of unintentional injuries, the initiative promotes better assessment of trends and prevention strategies for cases such as vehicle accidents related to alcohol intoxication or distractions while driving, drug overdose, misuse of drugs, and injuries related to falls. Other plans formulated by the initiative have been aimed at reducing injuries of the spinal cord, promotion of access to traumatic care services, prevention of poisoning mortality cases, and increasing the age-appropriate for using restraints for children in vehicles (Injury and Violence Prevention, 2019). Prevention of violence in the community can also be promoted through evaluation and provision of behavior change education to the community to curb bullying, prevent dating and sexual violence.
Some of the plans implemented by the healthy 2020 people initiative to reduce obesity rate and promotion nutrition include the provision of community education on healthy nutrition practices to people, encouraging people to limit their caloric intake, limitation of saturated fats consumption, and supporting agricultural policies (Nutrition and Weight Status, 2019). Aside from that, the initiative also promotes the reduction of economic prices for healthy foods.
The healthy people 2020 initiative aims at improving the quality of life for all people across the lifespan. The initiative works collaboratively with the government and private organization in promoting the health status of Americans. Increased lifespan and diversification of diseases influence the need to improve people’s health status. The healthy people 2020 initiative helps communities in resolving issues related to access to primary care and sensitizes communities on the need for providing healthcare services to all.
References
Alcala, H. E., Albert, S., Trabanino, S. K., Garcia, R.-E., Gilk, D. C., Prelip, M. L., & Ortega, A. N. (2016). Access to and use of health care services among Latinos in East Los Angeles and Boyle Heights. Fam Community Health, 39(1), 62-71. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4662077/.
Berger, R. (2018). Crime in greater Los Angeles: Expeiences and perceptions of local urban residents. Current Urban Studies, 6. (260-277). Retrieved from https://file.scirp.org/pdf/CUS_2018062813562733.pdf.
Centers for Disease Control and Prevention. (2016, November 30). Healthy People 2020: Legal and Policy Resources Related to Access to Health Services. Retrieved from Centers for Disease Control and Prevention: https://www.cdc.gov/phlp/publications/topic/hp2020/access.html
County of Los Angeles. (2013). Mortality in Los Angeles County 2013. Retrieved from the Los Angeles county department of public health: http://publichealth.lacounty.gov/dca/data/documents/mortalityrpt13.pdf
Health Quality Ontario. (2016). Interventions to improve access to primary care for people who are homeless: a systematic review. Ontario Health Technology Assessment Series, 16(9).
Healy, M. (2017, October 12). Nearly 4 in 10 U.S. Adults are not Obese CDC says. Retrieved from Los Angeles Times: https://www.latimes.com/science/sciencenow/la-sci-sn-obesity-rates-us-20171012-story.html
Injury and Violence Prevention. (2019, January 23). Retrieved from Office of Disease Prevention and Health Promotion: https://www.healthypeople.gov/2020/topics-objectives/topic/injury-and-violence-prevention
Nutrition and Weight Status. (2019, January 23). Retrieved from Office of Disease Prevention and Health Promotion: https://www.healthypeople.gov/2020/topics-objectives/topic/nutrition-and-weight-status
Sturm, R., & Hattori, A. (2016). Diet and obesity in Los Angeles County 2007-2012: Is there a measurable effect of the 2008 “Fast-Food Ban”? Social Science Med, 133. 205-211. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4410074/.