To begin with, the main stakeholders of this change proposal are medical professionals, financial experts, policymakers, healthcare experts, project director, and managers. For this reason, we believe that the Minnesota Department of Health/Jordan Health Department may be interested to invest in this project. Local healthcare providers including St. Francis Health Service and Open Door Health Center may benefit from further collaboration with us. At the same time medical practitioners are expected to join the program. The main beneficiaries are residents of Jordan, especially people with chronic diseases.
Social Determinants (Jordan, MN)
To begin with, citizens of Jordan, Minnesota, have access to health and primary care of quite a high quality. Medical services are offered by several providers covering different health insurance. For instance, St. Francis Jordan Clinic, deals with a range of health issues including adult and senior medicine, family medicine, pediatrics, and gynecology. The average physician of St. Francis Health Service in Jordan works with more than 1600 patients a year. Open Door Health Center (non-profit community health institution) provides citizens of different incomes with dental care. What is more, people can visit Cedar House Inc. for out-patient mental health care. The town has 14 city parks including Lagoon Park where 24 miles of sidewalks and trails can be found. Moreover, there is a Recreation Center that consists of a fitness center, an elevated walking track, and a 3 gym-station. The Food Pantry also operates and contributes to the wellbeing of low-income families.
More than 60% of local citizens receive their wages regularly. At the same time, employers offer a health insurance plan for 66% of their workers (“Economic development”, 2020). The median household income approximates to 69,000 USD what is slightly higher than the nationwide index in 2019. On the contrary, about 10% of Jordan’s population does not have insurance at all or are Medicaid members. These individuals require more attention from the government and society to increase the current welfare of the town. Addressing their needs should be a top priority of the county and local health initiatives.
Windshield Survey and Environmental Analysis
One of the community’s positive aspects is its annual population growth rate estimated at 1,25%. What is more important, young residents constituting the major age group of the current population. Most of the citizens have decent jobs with insurance coverage which increases their wellbeing. Housing quality is quite high, while the median home costs 209,000, which is 120,000 lower than the median home price sold in the US (329,000). As was already mentioned, Jordan possesses a number of parks, recreation zones, and centers necessary to live an active and healthy life. Moreover, Highway 169 offers restaurants and businesses ready to satisfy the needs of residents. Jordan Public Schools successfully meet the need for primary and secondary education providing both parochial and public opportunities.
Although the city of Jordan seems to be a great place to live, there are still some opportunities that should be seized. The estimated 10% of residents have restricted access to high-quality services available. In the current situation, they are deprived of wellness and health goods available to others. The 2020 County Health Rankings rank Scott County 4th overall for health behaviors and also 4th overall for health outcomes. Nevertheless, this source indicates that 4% are uninsured, 29% of adults suffer from obesity, 19% are physically inactive, and 12% of adults smoke (University of Wisconsin, 2020). Thus, obesity and linked chronic health issues such as type 2 diabetes and heart diseases are the main challenges for the community.
The proposed health care change is aimed to consolidate local health professionals and social activists, increase their involvement in advocacy for health and social change in the community. The majority of local physicians embrace their role as advocates of individual patients, while a wider and more comprehensive approach is neglected. Involved practitioners will meet together to design community-based programs to prevent and fight obesity, foster physical activity, and healthy eating. The are several active programs, including a community health improvement plan by Scott Public Health, the implementation plan of St. Francis Regional Medical Center, the SPAN program, and others. However, the mentioned programs are Scott-county based, thus, to be effective their implementation and toolkit should be revised at the local level.
Consolidated health care providers within St. Francis Jordan Clinic will consult IDM Best Practices Framework and the Healthy People Toolkit to use the best practice available in addressing obesity. The community-based obesity prevention planning should include community engagement, program design, evaluation, implementation and sustainability, and governance (King et al., 2011, p. 332). The organization’s further work should primarily encourage youth involvement in the advocacy that was successfully applied to fight substance use. Their participation would shift efforts from the individual level to the group one, increasing the evidence-based practice (EBP) influence on the community (Millstein et al., 2016). Incorporation of EBP into community-based programs is of top priority, as it reduces costs and helps to improve reliability, consistency, and quality of healthcare measures (Melnyk, 2014). According to Salas (2015), simplistic obesity public health proved to be ineffective due to the major focus on the individual level that leads to unintended consequences such as blaming overweight individuals. Instead, such initiatives should address socio-environmental determinants of health-supporting improved health rather than simple weight loss.
Higher advocacy practice of local health care providers and new programs are expected to hinder the development of chronic diseases, guide more residents to lead active physical life, to take personal precautions. A more active population will gradually eliminate the obesity issue improving overall health outcomes. It is especially important in times when the majority of deaths in the county currently related to the former problem. Hence, this change is beneficial for Jordan’s community which is the most important stakeholder.
In terms of the Minnesota Department of Health, the proposed initiative reinforces the established policies minimizing incurred expenses by modernizing it at the community level. The local health care providers, who are encouraged to collaborate, can improve the environment and welfare of the area in which they operate fulfilling their obligation. In their turn, health care practitioners receive a chance to fully play their advocacy role. Moreover, this initiative is expected to be backed by community members increasing overall trust and brand image of involved institutions.
If these opportunities are not addressed, the rate of chronic diseases would allegedly continue to increase year by year. It can be caused by a gradual rise in the share of residents suffering from obesity. Although already mentioned health county rankings improved since 2014, the obesity rate has gone up. Approximately 20% of residents encounter obesity, hypertension, and poor medical outcomes. The 1-10% of people who have restricted access to social and health services will continue suffering if we do not take consolidated action
This particular initiative for change does not require many resources and is based on the modern and effective model. However, there are potential barriers to change at organizational and governmental levels. The key one includes resistance from the health care professionals to play an extended advocacy role and apply new EB practices. According to Cabassa (2016), the absence of effective leadership, the inferior nature of communication, and the established culture are the main issues preventing change to be successful. Due to the lack of public health promotion culture in Jordan, the majority of essential stakeholders may stay aside from the program decreasing its chance for successful implementation. To reduce resistance, the change managers and leaders will encourage and educate all team members and key stakeholders on the anticipated gains, that are able to transform the lives of residents.
The change proposal’s main goal is to encourage local practitioners to join a major advocacy initiative. Moreover, the aim is to empower and educate the latter to implement new EB practices and design community-based programs addressing current health issues of Jordan. To make it possible, moderate financial support from funding agencies is needed. The majority of involved stakeholders will not have significant financial implications because the project is of consultative and training origin that is not resource demanding. On the contrary, the community itself and the government will save money spend on local public health in the long-run due to the initiative’s outcomes. Local businesses are not ready to provide insurance coverage to all people in need as it increases the labor cost (Liaropoulos & Goranitis, 2015). The drop in mentioned negative health outcomes will contribute to better insurance coverage in the future.
The program initially planned to last 12 months providing resources and knowledge to health care professionals and social activists. Based on the conducted assessment, the initial cost of the incentive is 10, 500 including expenditure on salary/wages and equipment. The project manager, as the main leader, will receive a 2,000 wage, while support staff will be paid 3,000. Writing materials, a laptop, and projectors require a one-time payment of 4,500 and would be used for the entire project. Projectors are needed for meetings with health care providers, organizing community campaigns, whereas a laptop is necessary to keep digital records. During the first year of the program’s operation, regular meetings and refreshments will require 1,500 dollars predominantly on rent. In general, the program’s functioning can be totally secured by 20, 000 USD of financial support. We believe in the active social position of the Minnesota Department of Health and St. Francis Regional Medical Center and hope to be granted this modest financial support.
Community Health Implications
The direct benefits for the community include a coordinated approach to local health care advocacy that will see more practitioners and private firms collaborate to implement new community-based programs. Medical support and social services will be encouraged to be more socially oriented addressing the needs of those uninsured or Medicaid members. It will improve overall access to health care services in Jordan.
The indirect community health implications are related to the further activity of encouraged and educated professionals. The obesity prevention programs based on new EB practices are expected to increase resident’s mobility, physical activity, reduce the obesity rate, modify the environment, and ultimately improve their health. This coordinated approach will lead to reduced cases of chronic diseases, longer life expectancy, and improved wellbeing for the majority of the population. As a result, the community is going to experience positive economic development of the region, higher quality of life, and better insurance coverage.
Cabassa, L. J. (2016). Implementation science: Why it matters for the future of social work. Journal of Social Work Education, 52(S1), S38-S50. Web.
Economic development. (2020). City of Jordan, Minnesota. Web.
King, L., Gill, T., Allender, S., & Swinburn, B. (2011). Best practice principles for community‐based obesity prevention: development, content and application. Obesity Reviews, 12(5), 329-338. Web.
Liaropoulos, L., & Goranitis, I. (2015). Health care financing and the sustainability of health systems. International Journal for Equity in Health, 14(1), 1-4. Web.
Melnyk, B. M., Gallagher‐Ford, L., Long, L. E., & Fineout‐Overholt, E. (2014). The establishment of evidence‐based practice competencies for practicing registered nurses and advanced practice nurses in real‐world clinical settings: Proficiencies to improve healthcare quality, reliability, patient outcomes, and costs. Worldviews on Evidence‐Based Nursing, 11(1), 5-15. Web.
Millstein, R. A., Woodruff, S. I., Linton, L. S., Edwards, C. C., & Sallis, J. F. (2016). Development of measures to evaluate youth advocacy for obesity prevention. International Journal of Behavioral Nutrition and Physical Activity, 13(1), 1-13. Web.
Salas, X. R. (2015). The ineffectiveness and unintended consequences of the public health war on obesity. Canadian Journal of Public Health, 106(2),79-81. Web.
University of Wisconsin Population Health Institute (2020). County health rankings and roadmaps. Web.