Jewish Population and History in Miami
- The Jewish population is ethnically diverse and steadily increasing.
- Miami was initially a Spanish colony without Jews.
- A significant immigration wave occurred in the 1930s
- High living standards attracted people from California.
- As the population aged, the community began to decline.
- The recent growth of the young adult Jewish population
Reasons for Choosing the Population
- Jewish young adults in downtown Miami
- The growing population of ~7000 impacting demographics
- Minority cultural background defines healthcare challenges.
- Limited resources may not support population needs.
- Diverse community from various backgrounds and cultural beliefs
- No information regarding the culturally competent approach
- Miami healthcare system unprepared to serve the Jewish community
Aggregate Description
- Life expectancy averaging between 81-85 years old (Central Bureau of Statistics, 2015).
- The low fertility rate of 1.5 children per adult
- High-risk social behavior such as smoking
- Cultural dietary habits lean towards fats and carbohydrates.
- Less than 50% practice leisurely physical activity (Benderly et al., 2017).
- Miami Jewish Health systems primary healthcare facility
- Approximately 30% live below the poverty level
Aggregate Health Risks and Treatment
- Leading causes of death: cardiovascular disorders and cancer
- High-risk factors for diabetes, hypertension, dyslipidemia
- Noticeable prevalence of higher weight amongst the population
- 20% are carriers of genetic disorders common to Jews (Warsch et al., 2014)
- Religion may impact attitudes and treatment choices
- Lack of competent cultural training to treat population
Analyzing Aggregate Strengths and Weaknesses
- Community assessment is necessary to develop strategies
- Culture affects an individual’s physical and psychological health
- Presence of cultural identity through Jewish institutions
- High life expectancy but significant percentage aging
- A sedentary lifestyle and smoking prevalence in the community
- Over 40% encountered anti-Semitic attitudes (Labgold, 2014)
- Socio-economic inequality limits access to health care
Family Description
- Family is historically and currently practicing Judaism
- Traditional family structure, three generations in the household
- Large house in a primarily Jewish neighborhood
- Cohesive familial ties and emotional relationship
- Open discussions are held about family issues
- Maintains access to health care services regularly
Risk Assessment
- Friedman Family Assessment Model utilized
- Occupations may cause elevated levels of stress
- Cardiovascular system disorders are prevalent
- History of cancer, diabetes, and liver issues
- Family predisposed to rapid progression of conditions
- Seek support to cope with stressful situations
Developing a Care Plan
- Using the Healthy People 2020 objective as guidance
- Vision To develop an intervention plan for aggregate
- The plan focuses on behavioral intervention and education
- Diagnosis of family includes imbalanced nutrition
- Occupational stress and exposure to physical activity
- Lifestyle can be targeted with behavioral intervention
Intervention Strategies
- Education promotes home-based self-care of family members
- Diet and activity addressed through instruction
- Instruction on health risks and proven strategies
- The intervention lasts eight weeks combining methods of education
- The practitioner provides access to community resources (Philis-Tsimikas & Gallo, 2014)
- Goal to direct family towards sustainable health
Education about Health Risks
- Intervention in health beliefs, attitudes, perceptions
- Disease-specific health risks and behaviors
- Critical to modify the diet to prevent chronic conditions
- Introducing moderate activity and strength training
- Activity and nutrition reduces disease risks
- Hypertension and dust allergy common noncommunicable conditions
- Disorders result in lower quality of life
Disaster Management Plan
- Necessary for cities to manage natural disasters
- An emergency preparedness plan limits adverse consequences
- Minimizes trauma and health risks during disasters
- Develops adaptation by promoting appropriate social behaviors
- Risk awareness ensures survival and individual resilience
- Timely resource preparation is critical for disaster situations
Family Disaster Education
- Management plan to create a fundamental knowledge base
- Acquisition of skills and acceptance of potential dangers
- Miami susceptible to hurricanes during certain seasons
- Health practitioner educates and helps to create a plan
- Evacuation routes, precaution measures, and checking contacts
- Preparing a disaster survival kit with supplies
- First aid training and psychological coping practices
Evaluation and Barriers to Implementation
- Tracking progress – fifth step MAP-IT model
- The assessment helps identify shortfalls and make corrections
- Environmental risks in relation to aggregate population
- Costs may discourage family member participation
- Costs include resources, materials, and consultations
- Costs are justified with long-term health benefits
Measurable Signs of Success
- Project realization is monitored and evaluated
- Recorded results identified and plan adjusted
- Subjective perceptions and objective data are analyzed
- BMI and physiological indexes are compared over time
- Weight loss, normalized blood pressure, and lipid content
- Monitoring cardiovascular risk factors and diabetes
Overview of the Aggregate Health Situation
- Currently, aggregate maintains access to health care
- Population growth and shortage of competent professionals
- Nurses require cultural training to treat the Jewish community
- Genetic predisposition, occupational stress, unhealthy diet
- Community-based prevention in disaster management plans
- The preliminary assessment helps manage environmental barriers
- Data evaluated to modify education and new interventions
References
Benderly, M., Chetrit, A., Murad, H., Abu-Saad, K., Gillon-Keren, M., Rogowski, O., …Kalter-Leibovici, O. (2017). Cardiovascular health among two ethnic groups living in the same region: A population-based study. International Journal of Cardiology, 228, 23-30.
Central Bureau of Statistics. (2015). Life expectancy, by sex, religion and population group. Web.
Labgold, M. (2014). Summary report of the 2014 Greater Miami Jewish Federation Population study: A portrait of the Miami Jewish Community. Web.
Philis-Tsimikas, A., & Gallo, L. C. (2014). Implementing community-based diabetes programs: The Scripps Whittier Diabetes Institute experience. Current Diabetes Reports, 14(2), 462.
Warsch, J., Warsch, S., Herman, E., Zakarin, L., Schneider, A., & Hoffman, J., …Barbouth, D. (2014). Knowledge, attitudes, and barriers to carrier screening for the Ashkenazi Jewish panel: A Florida experience. Journal of Community Genetics, 5(3), 223-231.