Addressing Diabetes and High Blood Pressure in Maryland’s Prince George County

This project paper aims to describe the population at risk of persons inside Cheverly Family Health and Wellness Centre, which is located in Mercy Lane, Cheverly, Maryland in Prince Georges County. This area became of interest after I had a chance of interacting with the community during my clinical rotation.  The population at risk in this area includes individuals of ages between 20 and 65 years who have diabetes. During my clinical rotation, I noted a high number of adults seeking medication due to high blood sugar most of whom could not afford treatment due to unemployment or poverty. Patients visiting the clinic had a chance to be assessed of high blood pressure before being served. Assessment sheet indicated a constant number of patient with high blood pressure thus a concern.  Therefore, it was important to conduct a community assessment through Windscreen survey and physical assessment. These methods were suitable to obtain information on PAR home, neighborhood, and community as a whole. 

Prince George County faces some health concerns, which warranted the county to launch a Health improvement plan to address the critical needs of its people. The county boasts a population of 908,049 people located in a land area of 482.69 square miles translating to 1,788 persons per square mile (Murphy, Xu, &Kochanek, 2013). Female population accounts for 51.9% of total population. The county is one of the richest African American popular counties in America.  86% of people over 25years in this county completed high school with 30% having graduated from college or university. The county contains modern highways built in 2007 as well as train service that traverses the county. The county is situated in the coastal plains characterized by gentle valleys and hills. Prince George’s median household income is about $74,260. According to research, the county has a birth rate of 11,931 babies and mortality rate of5, 327 deaths. The poverty rate and uninsured persons in this county are at 9.5% and 11.3% respectively. The life expectancy is 79 years with blood pressure being the top cause of death with a rate of over 26.2% of total deaths in Prince George. Statistics indicate that most people in this county experienced delayed medical care because they lacked timely appointments, lacked transport or long queues. Chronic diseases cause 70% of deaths yearly with cancer and heart disease being responsible for half of the deaths in Prince George County (Sadd, & Grinc, 2004). 

America encompasses people from various cultures accommodating the highest number of immigrants from all over the world. The country contains public health workers whose duty is to ensure that the health of the entire community is protected through preventing illness, promoting a healthy lifestyle and ensuring adoption of policies and laws that support public health. Although the most dominant race in the US is the whites, Prince George County has a high number of black people (Vital Statistics. 2011). Health is an important aspect of the society and everyone to proper medical care despite their age, race and cultural beliefs. The most challenging factor in accessing health is the cost of some of the services hospitals offer. It is noted that only few rich individuals all over the world can access the best health care services because they can afford the highest premium quality of health insurance. 

According to statistics, Prince George County has high median household income, education attainment, and individuals in the workforce as compared to the national figures. Report on Prince George health care indicated that the most vulnerable people are those with low income, the majority are Blacks and Hispanic most of which lack medical insurance approximately 35.7% (Murphy, Xu, &Kochanek, 2013.  Health statistic carried out on Cheverly Family Health and Wellness Centre indicated that the main determinants of whether a patient received medical treatment or not maybe due to poverty or lack of medical health insurance. Most of the

Adults above the age of 20 lacked health insurance.  Apart from high blood pressure, assessments indicate that most of the people in this area are affected by heart disease, asthma, and cancer with African-Americans being prone to attack. Furthermore, a significant number of residents of Prince George is experiencing homicide and obesity. 

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Another concern in this area is that most of the people that are 12% of adults struggle with a mental condition which results in suicide. In 2013, over 50 people lost their lives because of suicide (Quartely Workforce Indicators, 2013). The county contains various cities and towns. Currently, the county plans to improve the public health by providing quality health care and increase access and availability of quality services to assure its citizens of a good lifestyle. 

From the assessment in Cheverly Family Health and Wellness Center, increase in cases of high blood among the adults of age 20 to 65 years of age is attributed to poor nutrition and diet, cigarette smoking, not following medication rules, and lack of exercise (Sadd, & Grinc, 2004.  Most of the patients seen visiting the hospital are adults probably working with the forces. Patients seeking medication are married people with high level of education mostly graduates with no particular job. During collection of information, one could distinguish different classes of community people visiting the health care from the language they use, how they carry themselves, and approach in the facility. Salaried workers, that is, hourly workers visiting the healthcare facility were mostly seeking treatments and exhibited high blood pressure symptoms, unlike management who pursued means of preventing illness and development of high blood pressure. 

Since Cheverly Family Health and Wellness Center experience cold weather, most of the people prefer indoor exercise to escape the cold condition, snow mild temperatures. Winter is quite cold and gets 15 inches of snow per year compared to the US, which is at 26. Summer in Prince George is hot and experiences heat index of up to 32˚C (Sadd, & Grinc, 2004. Nutrition and dietary is another factor that aggravates high blood pressure. Junk foods and sugary foods like cupcakes, milkshakes, eggs, and chocolates are common foods for Cheverly Family Health and Wellness Center. High Blood Pressure booklet advises the community on a dietary program.  Following this program, for young people are challenging making high blood pressure inevitable.it is important to maintain a healthy life free of health disorders. The public health sector aims to promote quality health status, which will be important in ensuring a healthy life. Nurses together with patients should plan and come up with ways that improve their diets, exercise, and following doctor’s prescription. Since most of the patients are adults, they find it hard following doctor’s prescription on medicine.

The public health assessment role is to provide knowledge and create awareness to the community on the dangers of high blood pressure and means of managing it. This will be through a health fair where the public will be taught on living quality life, nutrition, exercising, and how to live with hypertension. Furthermore, any questions they have will be answered. Education materials on high blood pressure will be provided. PAR was given a chance to attend counseling and personal appointments with nurses who will help the patients with high blood pressure. This policy will serve as a basis to ensure the community is advised as a way of introducing an upstream thinking to the community. The PAR should be encouraged to seek treatments and further consultation. This policy aims at reducing factors that contribute to poor health in the communities and promote ways of improving health care, which is a measure of development. People living in the communities should push for adoption of such policies as a way of supporting laws and plan that aim at improving public health. 

Finally, the main recommendation from this project is evaluation and follow up a plan for patients treated with high blood pressure.  Patients are visiting Cheverly Family Health and Wellness Center for medication on hypertension by having a follow-up sheet that covers their detail for a specific period. This information on follow up should be kept confidential and only communicated to the nurses who will do a follow up on changes in diet, follow up with doctor’s prescription, weight, and body mass index of patients.  Numbers ranging from C1 toC20 will be used to identify the patients during data collection, which will be fed into a computer to produce information, which will cover body mass index, decrease or increase in weight, medication, and diet. From this information, the factor that has great contribution in controlling high blood pressure will be recommended for further studies. 

Data on the patients will be recorded in the client’s broadsheet for the period of study to avoid confusion and ensure related work. The study is to identify which factor contributes to reducing high blood pressure in patients. 

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