This paper serves as a compilation of several assignments undertaken pertaining to health assessment. The essay begins with a brief description of this student’s home county and follows this with the lengthy explanation about the primary health concerns of the elderly in Dupage County. Models on health assessments are discussed as well as the strategies to gather data for the health assessment.
Demographic information from US Census
Dupage, Illinois has a population of 22,241. Of this figure, there are 18,104 Whites or 81 percent of the population. Asians comprise 11 percent or 2,647 persons. The elderly population has a large share with 17% of the population or 3,914 individuals. One-third of the residents are children numbering 8,925 while persons with disabilities totalled 2,859.
Primary health concerns of the elderly
Two health issues considered of primary concern for the elderly are colon cancer and heart disease. Colon cancer manifests itself through changes in bowel movement, blood in the stool, and pain in the stomach. It actually begins as tiny polyps that are benign, however over time these growths can become malignant over time. Heart disease, in turn, refer to various ailments affecting the heart such as arrhythmia, heart failures, arthrosclerosis, and angina. Both diseases are preventable and treatable when diagnosed at the early stages. A colon cancer prevention study for colon cancer has also been conducted at the Edwards Hospital in the state of Illinois. Here, patient participants would be taking the experimental drug Rosuvastatin to reduce the risk of colon cancer, every day for five years (Pavlik, 2013).
There are existing programs that are aimed at preventing and catching these diseases at the early stages. Preventive methods for colon cancer are consumption of more fiber rich foods, exercise, and taking daily dose of vitamins. In the Dupage County, the County health department encourages educational classes about colon cancers. Since colon cancer is among the four kinds of cancers with effective cancer screening tests (BVHS.com), it is highly encouraged that individual at risk of this disease are tested. Screenings are being done in hospitals and county residents aged 50 and above are strongly advised by the County Health officials especially because colon cancer can be successfully treated when caught at early stage.
Dupage County has at least three programs aimed at women and the prevention of heart disease. One is the Illinois Wisewoman Program which conducts education and awareness campaigns to reduce heart disease and other diseases in women aged 40 to 60 years old. This program, however, is limited to members of the female population with no insurance or insufficient coverage. Other programs are Naperville PE4Life and Healthy-Walk. The former focuses on preparing healthy recipes and growing fresh vegetables at home while the latter is an exercise program that can be initiated by a community leader. All these initiatives emphasize the value of increased awareness, exercise, and preventive measures to decrease the risk of heart disease. Although primarily catering to women, these programs may also be have their male counterparts.
Health assessment process of LA County
This researcher looked into the health assessments launched by the LA County in California and published online at the Public Health website (www.publichealth.lacounty.gov). From the scope and breadth of their studies, this researcher assumes that health assessment is a priority function in the LA county health department. Stakeholders must have been identified early on at the conceptualization process before any assessment is undertaken. Another assumption is the allocation of resources for personnel and assessment –related activities. These personnel are most likely highly qualified with academic backgrounds and practical experience to be able to efficiently carry out health assessments.
The study that this researcher found particularly relevant was the health assessment on adult smoking . This study presented a table which detailed the prevalence of cigarette smoking of 18 persons 18 year old and older from 1997 to 2002. This particular graph shows the importance of having a baseline information. The table shows how many people smoke in terms of gender, race, age groupsm residence, in three different time periods—1997, 1999, and 2002. This table alone can help in planning health interventions for any kind of issue that can be based on gender, age group, and residence.
The two other information that are likewise relevant are (a) reasons for the decline in smoking; and (b) ongoing efforts that are needed. For any health assessment it is important to identify the reasons community members decide to address the health concern. The list of needed interventions (either being implemented already or still needs to be launched) is also important to be able to check which are effective, accepted, and still necessary.
The information about what interventions work and what are still needed are information that can be used in public policy planning. Since the LA County website contain assessments that have already been conducted, these studies actually provide case studies of what works and what do not. These are concrete reference materials for the policy recommendations that can be done in other counties conducting health assessment in their communities.
Health issue: Early detection of cancer and heart disease among the elderly
Cancer and heart disease are the leading causes of death in the US. In the Dupage County 34 percent of deaths among Whites, over 65 years old are caused by heart disease. For the Blacks, heart disease claims 32 percent of deaths, for Hispanics it is 24 percent and for other races, it is 36 percent of deaths attributed to heart disease. Among the 45-65 age group, heart disease still claims 25 -30 percent of deaths among the different races (HRSA, 2000). The focus of the health assessment shall be the adult and elderly population. The rationale for holding such assessment is the need to institutionalize activities for the early detection of cancer and heart disease especially among the adult and elderly population.
Conducting health assessment in the community
Health assessment is defined by the US Department of Health and Human Services (USDHHS) as “any analysis of health-related data that evaluates health status or health risk at the individual or organizational level” (Anderson, Serxner & Terry, 2002, p. 218). Health assessments data are critical to effective public health implementation. These data are key to the assessment of progress made by individuals as well the overall impact of the program from a comprehensive perspective.
Health assessments are important sources of information for health implementers especially in instances when vulnerable groups do not actively seek out health services or are prevented from doing so by factors such as distance, lack of transportation, and financial constraints. In the study of independently living seniors in Southern Illinois conducted by Whitney, Visker, Haithcox-Dennis, & DeWeese (2012), the researchers found out that 56 percent of the 85 seniors respondents do not have an emergency plan. A third of them have no bottled water or a first-aid kit and only a few of them knew the items that should be included in a 72-hour emergency kit. Most of the research participants “felt that local health departments should provide warnings, food, shelter, transportation, help to the injured, and medications during an emergency” (Whitney et al., 2012, Abstract). When health assessments are conducted, information about the situation among vulnerable groups becomes accessible and would contribute to program planning activities for the elderly sector. The study further recommended that in order to enable seniors to be more prepared in times of emergency they should be informed about what to do and where to go in these instances.
In the case of the Dupage county, the health assessment is expected to generate data about available cancer screenings tests or programs implemented in the community that educate residents about the value of making a lifestyle change to improve the family’s health. The health assessment process entails identifying stakeholders, preparing an assessment tool, collecting and analyzing data, and validating assessment results and recommending interventions.
Identifying and mobilizing stakeholders. Stakeholders are those “involved in program operations;” “served or affected by the program;” and “users of the evaluation findings” (Introduction, n.d. p.1). Adult population aged 45-65 years old as well as the elderly population aged over 65 years old are the primary stakeholders of the health assessment. The tables below describe the three kinds of stakeholders in the health assessment project.
Preparation of a health assessment tool. Project team shall work with identified stakeholders to develop the assessment tools that are most appropriate and feasible. For example, families of the elderly and/or patients would be consulted about terminologies used when interviewing the elderly and patients to prevent offending survey respondents or key informants. Project team shall prepare the questionnaire and interview questions in consideration of the results from consultations and preliminary meetings with stakeholders. It is also important to refer to existing literature about effective data collection methods. For example, in the study of Bosompra, Ashikaga, & Ruby (2004) about influenza immunization intentions of the elderly in Vermont, the researchers conducted telephone interviews with 799 elderly persons who were 60 years old and above. They had a 65 percent response rate. This study looked into attitudes and perceptions of the elderly and the means of generating the information proved to be effective
Launching the health evaluation. Stakeholders will be invited to take part in the assessment process. The methods used to gather information will include focus-group discussions, semi-structured interviews, surveys, and participant observation. Data collected will be collated and subjected to statistical analysis. The results of the assessment shall be written in a report and presented to the stakeholders for validation.
Validating health evaluation and generating an action plan
The purpose of the health assessment was to generate a document that can support policy recommendations. Thus, when results of the assessment have been organized in a report, this shall be presented to the stakeholders in a validation workshop. The aim of this activity is to validate individual recommendations and to generate more suggestions that can be used for formulating policy that will address the health issue of heart diseases and cancer among the adult and elderly population. It is expected that an action plan involving the stakeholders’ participation will be generated by the health assessment activity.
Health assessments and health promotion
The World Health Organization (1986 as cited in Harris & Fries, 2002) defines health promotion as the “process of enabling people to increase control over, and to improve their health” (p.1). In the US health promotion activities are aimed at changing behaviors and enabling a shift into healthier lifestyles. A healthy lifestyle, in turn, is associated with decreased mortality, lower morbidity, and less medical costs (Harris & Fries, 2002). However, it does not necessarily follow that the mere presence of a health promotion program would immediately result in lifestyle changes or paradigm shifts in health-related perspectives.
Thus, there is a need for health assessments to determine whether existing health promotion programs are effective and have generated positive results in the lives of the residents. For example, have these programs reduced or cases of common ailments such as respiratory diseases? Is the demand for medically marginal services reduced? Finally, to be considered successful, these programs should have facilitated the build-up of self-managements skills. It is not sufficient to educate and increase residents’ awareness about health issues. Health promotion programs should enable residents to effectively managed their individual health.
Conclusions
Health assessment is an important activity in public health. Through this activity, stakeholders become aware of the status of the implemented health programs. By gathering information about the residents in a particular area, both implementers and participants are informed about the existing conditions pertaining to health. The results of the health assessments are utilized by those who are implementing the health programs, those who are served by the program, and policy makers. Therefore, it is important that all stakeholders are given an opportunity to become involved in health assessment. The project team who shall facilitate the data-gathering processes are also expected to be objective, fair, and sensitive to the needs/feelings of the other stakeholders. As this project focuses on the health issues of the elderly, the results of the health assessment are expected to generate improved services for this vulnerable sector particularly in education sessions, cancer screenings, and preventive measures for heart disease.
References
Anderson, D.R., Serxner, S., & Terry, P.E. (2002). Health assessment. In M.P. O’Donnell (ed.), Health Promotion in the Workplace, 3rd edition. Albany, NY: Thomson Learning, Inc., pp. 218-243.
Bosompra, Ashikaga, & Ruby (2004). Attitudes, perceived norms, and intentions: A needs assessment study of the influenza immunization intentions of elderly citizens in Vermont. Journal of Rural Health,20 (2), pp. 125-130. DOI: 10.1111/j.1748-0361.2004.tb00018.
Harris, J.S. & Fries, J. (2002). The health effects of health promotion. In M.P. O’Donnell (ed.), Health Promotion in the Workplace, 3rd edition. Albany, NY: Thomson Learning, Inc., pp. 1-22.
Health Resources and Services Administration (HSRA). (2000). Community Health Status Report: DuPage County, Illinois. [online] Available in < http://www.nibidc.com/chsr/dupage.pdf> [Accessed 14 May 2013].
LA Pubic Health. (2003, December). Adult Smoking. [Online] Available in
Pavlik, M. (2013, March 6). Edward seeks colon cancer patients for polyp prevention study - Naperville, IL Patch. Naperville, IL Patch - News, Sports, Events, Businesses & Deals. Retrieved April 15, 2013, from http://naperville.patch.com/announcements/edward-seeks-colon-cancer-patients for-polyp-prevention-study
Whitney, E., Visker, J., Haithcox-Dennis, M.J. & DeWeese, A. (2012). Independently Living Rural Seniors and Emergency Preparedness: A Pilot Study in Southern Illinois. The Health Educator, 44 (1), pp. 21-27.
________. (nd). Introduction for Public Health Programs, Worksheets for Unit 8 Program Evaluation.
