1. Poverty is a cause of poor health in a community. “The biggest enemy of health in the developing world is poverty”, these are the words of Former Un secretary general Koffi Annan in his2001 address to the World Health Assembly. Globally, there is a definite relationship between poverty and poor health. Life expectancy in the Least Developed Countries is just 49 years and ten percent of newborn children do not reach their first birthday (Allen, 2006, pg.73). Interestingly, in highly developed countries, the average life span is 77 years and the infant mortality rate is six per 1000 live births. Poverty creates ill- health because it forces people to live in environments that make them sick, without decent shelter, clean water or adequate sanitation. Poverty creates hunger, which in turn leaves people vulnerable to disease. Poverty denies people access to reliable health services and affordable medicines, and causes children to skip routine vaccinations. Poverty creates illiteracy, leaving people poorly informed about health risks and forced into dangerous jobs that harm their health.
Poor health causes poverty. Various researches have come up with illness as the number one cause of poverty ahead of losing a job. Good health is identified as a fundamental component of a good quality of life. Sickness of the family breadwinner is something that people particularly fear. This implies that food and income are suddenly put to a halt. Payment for treatment and purchase of drugs lead to more impoverishment causing a downward spiral of poverty. The affected family experiences food shortage, children are forced to withdraw from school and sent to various errands in search for money to sustain the family. Different views on poverty as a cause of poor health in the community and poor health as a cause of poverty in the community are likely to affect public health policy. Public health policy intends to prevent diseases, prolong life and promote health of the general public by making thorough and informed decisions. Such differing views on poor health and poverty, and how they are related maybe the cause of misunderstanding of the public health policy.
2. The determinants of health model attempts to map a relationship between an individual, their environment and disease. Individual are located at the center with a fixed set genes. They are surrounded by influences on health, which can be modified. The first layer is personal behavior, the second layer is social and community influence and the final layer includes structural factors such as housing and working conditions. A disease like HIV/AIDS is likely to be influenced by various components of this model. Individual risk behaviors influence the probability of coming into contact with individual infected by the disease. HIV/AIDS is a sexually transmitted disease; therefore, an individual sexual risk behavior usually occurs in the context of sexual relationship or relationships with other individuals. These relationships are then located in a wider sexual network. Other risky individual behaviors such as taking alcohol also increases the chances of being infected with HIV/AIDS since alcohol affects decision-making and judgment abilities of an individual therefore exposing them to manipulation. Social and community networks are impacted by HIV/AIDS in that, an infected individual in a given social circle is likely to spread the disease by infecting their close associates in the society. On the other side, HIV/AIDS affects the social community by taking making strong and healthy individuals ill, reducing the economic output of such a social community. The social community is also affected by HIV/AIDs in that, members of a given social community have to spend time offering their moral support and caring for those bedridden due to HIV/AIDS. General socioeconomic, environmental and cultural conditions affect the spread of HIV/AIDS. Individuals living in poor conditions are likely to engage in reckless activities, which lead to spread of the disease. The education level of individuals will influence their decision making when it comes to taking safety measures, to avoid contracting the disease. The less educated are likely to be more affected by HIV/AIDS. Working conditions play a role in the spread of HIV/AIDS; individuals working under poor conditions are unlikely to afford the cost of various safety measures to avoid being infected with HIV/AIDS. Lack of good health care services in a certain region will lead to more people getting affected by HIV/AIDS due to lack of special care required for HIV/AIDs patients.
3. Infant mortality, which is the death of a child before they are one year old, is one of the conditions that have significant impact on maternal and infant health. The five strategies of health outlay the various interceptions that can be made to avoid infant mortality. The first strategy encourages building of a healthy public policy (Linsley et al, 2011, pg.28). In this case, an intervention is made by establishing three priorities maternal and infant health outcomes such as preterm birth, breastfeeding and maternal mortality. These priorities are laid down in an agenda, which is then put into place to ensure reduced infant mortality. The second strategy is creation of supportive environments for health. An intervention in this case involves ensuring that women who have experienced adverse pregnancy outcomes receive inter-conception health care to prevent ensuing preterm births. The third strategy is strengthening of community action for health. An intervention in this situation involves support and implementation of nationwide Medicaid standards for comprehensive prenatal care. The fourth strategy is the development of personal skills. An intervention to prevent infant mortality in this case will involve utilizing professionals such as lay health supervisors to reinforce health education to pregnant women to improve their personal skills in taking care of the child once they are born. The fifth strategy involves re-orienting health services. An intervention to prevent infant mortality by this strategy will involve provision of routine health visits to pregnant women screening for risk factors is done to avoid complications at the time of birth. In prevention of infant mortality various interventions can be done across the three levels of preventive interventions. In the primary intervention level where the goal is to protect healthy people from developing a disease or getting injured, a preventive intervention would involve provision of regular screening for the pregnant woman so that any abnormalities are noted early enough and avoid complications while giving birth. In the secondary prevention level, interventions happen after realization of serious risk factors. In this case, an intervention to avoid infant mortality will involve provision of timely and continuously comprehensive prenatal care to a pregnant woman who has been identified to be at a risk of experiencing complications during birth. At the tertiary prevention level, the focus is on helping people manage complex health problems. During birth an intervention of such level can be made to avoid infant mortality. For instance, presence of highly skilled attendants at birth who can quickly notice life threatening complications which are common while giving birth.
4. State’s police power is the capacity of the states to control behavior and impose order inside their territory for the improvement of health, safety, morals and general well-being of the inhabitants of the particular state (Schultz, 2009, pg.559). Through state’s police power, the state can establish a means by which the community can enforce civil self-protection rules. Through state’s police power, the state can pass and enforce isolation and quarantine, health, and inspection laws. Such a move would interrupt or stop the spread of a disease around the state. A recent case is the state-imposed quarantine at the Maine home of nurse Kaci Hickox to avoid spread of Ebola since the nurse returned from Sierra Leone where she had been working with Ebola patients.
5. The Mobilizing for Action through Planning and Partnerships (MAPP) is described as a planned approach to community health enhancement (Hodges & Videto, 2011, pg.10). One area that is ripe for community health education in San Bernardino is the area south of the San Bernardino Mountains adjacent to riverside. This area is the most populous in San Bernardino County with a population of around two million people. Since this area is highly populated, it is necessary to develop a MAPP, which can aid in handling of health issues in the area. A road MAPP for strategic use in the area will be made up of:
(i) Organization for success and development of partnerships. At this phase, groups of members are recruited to form a committee that will plan and organize the required activities in San Bernardino county area.
(ii) The visioning phase where the members of the committee and San Bernardino inhabitants work together in development of vision accepted and shared by everyone in the community.
(iii) The assessments phase. Four assessment of the Sab Bernardino community are carried out in this phase. These assessments include The Community themes and strengths assessment, the local public health system assessment, the community health status assessment and the forces of change assessment. These assessments are to be carried out in accordance with the National Public Health Standards program local instrument.
(iv) The fourth phase will be the strategic issues phase. The community members of San Bernardino together with the selected committee members examine the collected information so that they identify the key issues that need to be addressed to realize their vision.
(v) After identication of strategic issues, goals are set for each issue under the basis of the vision and assessment data. These goals should indicate the route from the present San Bernardino community health status to the future vision that has been laid out.
(vi) The last phase is the action cycle, which comprises of planning, application and assessment of the actions taken by the group to achieving the vision.
6. The current Ebola concerns have prompted different branches of National, State and Local health agencies to react in different ways. Most healthcare centers are bust preparing them in case Ebola invades their center. Clinicians in such centers receive specialized training in accordance to various outlined guidelines. Various states have developed risk communication strategies for the public, which include messages containing information on Ebola. The state has ensured that state and medical staff is aware of the current recommendations for travellers and movement of people exposed to EVD.
References
Allen, J. L. (2006). Student atlas of world politics. New York: McGraw-Hill.
Linsley, P., Kane, R., & Owen, S. (2011). Nursing for public health: Promotion, principles, and practice. Oxford: Oxford University Press.
Schultz, D. A. (2009). Encyclopedia of the United States Constitution. New York: Facts On File.
Hodges, B. C., & Videto, D. M. (2011). Assessment and planning in health programs. Sudbury, MA: Jones & Bartlett Learning.
