Part 1:
- Introduction
Part 11:
- Body
Part 111
- Conclusion
Abstract
Leadership in nursing includes both formal and informal roles. Demonstrating nursing leadership includes initiating change to improve the health and wellness of a community. It does not entail being in a managerial position to effect change. As such, this presentation will encompass an evaluation of a community problem in Florida and presentation of a plan to address the issue.
Part 1: Introduction
Opa Locka is a rural community situated in Miami Dade country. It has a population of approximately 15,219 people according to the 2010 census bureau figures. There are 5, 207 housing units. 69.4% of the population is African Americans; 28.5% Hispanic; 22.8% white; 0.35% Native Americans and 0.21 Asians. A negligible percentage of 3.6 are of other unclassified ethnic orientation. Males have a media income of approximately $22, 347 annually while women annual median income is $19,270. Importantly, the dominant language spoken in this community is English accounting for 68%; next is Spanish 28.2%, French creole 2% and French 0.47% (US Census Bureau, 2010).
Significantly 32% of the population is below the standard poverty line. Of this amount 42% are under the age of 18 and 40% over age 65. Consequently, a 2013 Miami Times relating the crime rate in Opa Locka described the phenomenon as a plague, which is skinning the environment. Citizens are blaming the decline in police vigilance of the Opa Locka as being responsible (Godfrey, 2008).
Hence, escalating crime rate and poverty are the two major public health issues in this community. These insidiously contribute towards large populations of uninsured/underinsured persons in this rural landscape. It obviously exceeds the proportions observed in urban locations. In concluding my assessment using data derived from United States Census Bureau the visible problem was identified as poverty and crime which have a direct relationship to an uninsured status. Supporting data revealed that 42% of children in the community were below the poverty line and 40% age 65and over were experiencing the identical socio-economic difficulty. Opa Locka is the listed as 7th community with the highest rate of property crime in the country (Godfrey, 2008).
Part 11: Body
Paragraph 1
America’s healthcare system is one in which a citizen or resident must have health insurance to access healthcare. Due to unreasonable cost of health insurance some 60% of Americans are uninsured because they cannot afford to pay for health insurance. As such, in situations where poverty and crime intermingle it becomes even more difficult to find money for health insurance. Anthony R. Eves and Keith Mueller (2013) researched ‘State Health Insurance Exchanges: Assessing Rural Implications of Statutes.’ The researchers analyzed ‘how five characteristics of health insurance exchanges might address particular rural concerns’ (Eves & Muller, 2013, p.1). Five key characteristics identified, which could hinder insurance coverage of residents living in rural areas such as Opa Locka were market function; governance; enrollment; access standards and certifying qualified health plans (Eves & Muller, 2013). While these may appear remote to the real problem of predisposition of poverty and crime combination the usefulness lay in discerning that with poverty and crime people seldom gravitate towards providing for themselves in this way. It is striving for survival perhaps coping with incidences of jail terms and lack of eligibility to work legally. Therefore, making health insurance accessible to their needs is important. The truth is that health insurance plans are very expensive for the poor.
Paragraph 11
Erika C. Ziller, Jennifer D. Lenardson and Andrew F. Coburn(2011) highlighted some interventions which have been enacted to address this problem and presented them in a documentation entitled ‘Health Care Access and Use Among the Rural Uninsured’ (Ziller et.al, 2011). Researchers admitted that being uninsured denotes poor access to healthcare. More importantly, access to quality health care is denied since Medicaid offers minimal access. Adults over 65 who have only Medicare part A and B without accompanying HMO coverage are at a greater disadvantage. Subsequently, researchers recommended that the Affordable Care Act (ACA) designate a further $8M towards resolving this issue (Ziller et.al, 2011). Similarly, Jennifer King and George M. Holmes (2011) in their research highlighted ‘Recent Changes in Health Insurance Coverage in Rural and Urban Areas.’ These processes and polices have become ineffective since the unemployment escalating rates in America has pushed 5.6 million more people into becoming uninsured during 2007-2009. Therefore, uninsured in rural communities has reached epidemic proportions. In response there have been significant increases in coverage for children with Medicaid. Rural residents 65 years and older have been educated towards open enrolment periods when they can access supplemental coverage through HMOs (King & Holmes, 2011).
Paragraph 111
Ultimately, in discussing my analysis of this issue from the viewpoint of a nurse leader in the community with the aim of developing possible solutions is to first devise strategies for assisting Opa Locka residents find alternative employment beside crime. When residents are convicted of a crime they are denied access to employment. Therefore, upon release from prison they cannot function within the society in any other way but to pursue a crime career. The dilemma is poverty, crime, unemployment, crime, poverty. It is a misery go-round-cycle for this community. In taking steps to resolve the poverty/crime syndrome and consequences of being uninsured is accessing stake holder participation by approaching the mayor of Opa Locka with suggestions for. The psychology of crime and recidivism is not secret to the average American politicians. Perhaps, this is why more money is expended on building larger prison since once they keep doing the same thing the identical results will come forth. The only way to expect change is to change. People who are released from state prisons must be offered opportunities to positively synchronize with their communities. Depending on how long they are incarcerated when inmates leave the prison they learn skills, but few opportunities are thee to practice them. Therefore, the mayor must take personal interest in reforming Opa Locka by positively intervening in this dysfunction in an effort to resolve the issue.
Paragraph 1V
After addressing the poverty/crime abnormality, Keith J. Mueller, Andrew F. Coburn, Jennifer P. Lundblad, A. Clinton MacKinney, Timothy D. McBride, and Sidney D. Watson (2011) outlined ‘The High Performance Rural Health Care System of the Future.’ My leadership and management skills as a nurse could be employed to effect change in this situation by adapting their guidelines. These researchers identified affordability, accessibility, community focus, high quality, and patient centeredness as being the foundation of resolving uninsured issues within rural communities. As such, linking forces with community groups I would lead the way in designing projects where Opa Locka residents could be educated about affordable health insurance coverage; access to it their community bringing the services to them in their homes through a door to door intervention passing out pamphlets.
Part 111
Conclusion
Poverty and crime have been identified as being positively related in assessing uninsured status of Opa Locka residents. Research has revealed that even though residents have Medicaid and Medicare coverage lack of education on how they are applied to health care availability has limited access to quality care. Strategies to relive poverty and crime syndrome within the society have been advanced. Ultimately, as nurse leader in the community, I would design programs to educate resides pertaining to the availability of insurance service, which are accessible to them
References
Eves, A., Mueller, A. (2013). State Health Insurance Exchanges: Assessing Rural Implications
of Statutes. Rural Health Research and Policy Centers.
Godfrey, C. (January 30th 2008). Opa-locka Boots the Boss. Miami New Times.
King, J., & Holmes, G. (2011). Recent Changes in Health Insurance Coverage in Rural and
Urban Areas. North Carolina Rural Health Research & Policy Analysis Center
Mueller, K. Coburn, A. Lundblad, J. MacKinney, C. McBride, T., & Watson, S (2011).
The High Performance Rural Health Care System of the Future. Robert Wood
Foundation. Rural Policy Research Institute.
Ziller, E. Lenardson, J., & Coburn, A. (2011).Health Care Access and Use Among the
Rural Uninsured. Maine Rural Health Research Center
