Policy Analysis

Full Answer Section

• Mental Health: Mental health concerns are on the rise, with limited access to mental health services for underserved communities.
• Infant Mortality: Racial and ethnic disparities persist in infant mortality rates.

2. Problematic Area of Interest: Addressing Social Determinants of Health

These indicators highlight the need for advanced nursing practice to focus on social determinants of health (SDOH). SDOH are the economic and social conditions that influence health outcomes. By addressing these factors, nurses can play a vital role in promoting health equity for all residents.

3. Evaluating Health Policy Options

Policy Option 1: Expanding Community Health Worker Programs

• Description: Community health workers (CHWs) are trusted members of the community who provide education, social support, and health navigation services to underserved populations.
• Evidence: Studies have shown that CHW programs can improve health outcomes, increase preventive care utilization, and reduce healthcare disparities. (https://archive.cdc.gov/www_cdc_gov/dhdsp/pubs/toolkits/chw-toolkit.htm)
• Policy Analysis Tool: The RE-AIM Framework (Reach, Effectiveness, Adoption, Implementation, Maintenance) can be used to evaluate this option.

Policy Option 2: Implementing Healthy Food Financing Initiatives

• Description: These initiatives provide incentives for grocery stores to locate in underserved communities and offer healthy food options. They may also include programs like food vouchers or prescription programs for fruits and vegetables.
• Evidence: Studies have shown that such initiatives can improve access to healthy food and contribute to healthier dietary patterns in low-income communities. (https://www.rd.usda.gov/about-rd/initiatives/healthy-food-financing-initiative)
• Policy Analysis Tool: The WHO Health Equity Impact Assessment Tool can be used to evaluate the potential impact of this option on health equity.

Policy Option 3: Expanding Medicaid Coverage and Access

• Description: Expanding Medicaid coverage can increase access to preventive care and chronic disease management for low-income residents.
• Evidence: Studies have shown that Medicaid expansion can lead to significant improvements in health outcomes, particularly for low-income adults. (https://www.nber.org/system/files/working_papers/w25105/w25105.pdf)
• Policy Analysis Tool: A cost-benefit analysis can be used to evaluate this option, considering the potential health improvements and budgetary impacts.

4. Prioritization and Recommendation:

Prioritized Policy: Expanding Community Health Worker Programs

Rationale:

• CHW programs offer a targeted and cost-effective approach to addressing SDOH.
• Nurses can play a key role in developing and leading CHW programs.
• CHWs can build trust and rapport with community members, addressing specific needs and promoting health literacy.

Implementation Considerations:

• Collaboration with community organizations and local government is crucial.
• Training and support for CHWs are essential for program effectiveness.
• Evaluation and data collection are needed to demonstrate program impact.

Advanced Nursing Practice and Advocacy:

Advanced practice nurses (APNs) can play a vital role in advocating for policies that address SDOH. They can:

• Provide data and evidence to support policy initiatives.
• Partner with community organizations to advocate for change.
• Educate policymakers and the public about the importance of addressing SDOH.

By focusing on social determinants of health and advocating for policies like expanding CHW programs, advanced nursing practice can make a significant contribution to improving health equity and well-being in Miami-Dade County.

Sample Answer

1. Exploring Health Indicators in Miami-Dade County

Miami-Dade County boasts a vibrant community, but significant health disparities exist within its population. Resources from the Miami-Dade County Health Department (https://miamidade.floridahealth.gov/) and the 2022 Community Health Assessment (https://www.healthymiamidade.org/) reveal concerning trends:

• Social Determinants of Health: Low-income populations, racial and ethnic minorities, and immigrants face higher risks of chronic diseases like diabetes and heart disease. Access to healthy food, quality housing, and preventive care is often limited.