Name
Chamberlain University
NR-717: Concepts in Population Health Outcomes & Health Policy
Prof. Name
Datea
Hello esteemed officials at the Mississippi State Department of Health,
My name is Angelica Waller, MSN, BSN, RN, and I am currently advancing my education by pursuing a Doctor of Nursing Practice (DNP) in Healthcare Leadership at Chamberlain University. Over the past seven years, I have served as a registered nurse in multiple healthcare settings, including hospitals and outpatient clinics. Presently, I am the nurse manager of a step-down intermediate care telemetry unit at Moore’s Park Memorial Hospital.
My nursing career began at the bedside as a floor nurse, where I actively volunteered at local community clinics to provide care to uninsured and underserved populations. Even after transitioning into a leadership role, I remain committed to service by organizing mobile health clinics, community outreach events, and health education workshops. My academic and professional interests center on improving health equity, expanding access to care, and advocating for sustainable funding in public health services, particularly for populations disproportionately impacted by hypertension and cardiovascular disease.
Citizens residing in Jackson, Mississippi—especially within the African American community—experience alarmingly high rates of hypertension, which often progress into chronic cardiovascular conditions.
This concern is critical because social determinants of health—including low socioeconomic status, limited education, and restricted access to healthcare coverage—are directly linked to hypertension-related disparities. If left unaddressed, these barriers place African Americans at an increased risk of premature death, poor health outcomes, and reduced quality of life.
This issue aligns with the mission outlined in H. Res. 238 (IH), 114th Congress (2015), which sought to highlight health disparities during National Minority Health Month. The populations recognized in this resolution included African Americans, Hispanic Americans, Native Hawaiians, Alaska Natives, American Indians, Asian Americans, and Pacific Islanders.
For Jackson, Mississippi, addressing hypertension is a public health priority. The persistent lack of affordable insurance, structural inequities, and low health literacy demands system-based policies and sustainable interventions to improve outcomes.
The Mississippi State Department of Health (MSDH) holds a central role in promoting equity and addressing preventable health challenges. Mississippi consistently ranks as one of the highest states for heart disease mortality, with recent data placing it second nationally (McCoy, 2024).
Although the Affordable Care Act (ACA) Medicaid expansion improved coverage, significant gaps remain. Adults living below the poverty line without dependent children are often left without affordable health options (Raphael & Rudowitz, 2024). Consequently, many individuals delay or completely avoid care, worsening their conditions.
As a practicing nurse in underserved settings, I have seen firsthand how financial barriers, fear of medical debt, and distrust in healthcare systems prevent patients from seeking timely care. Additionally, low health literacy often leaves patients unable to manage chronic diseases such as hypertension.
One powerful illustration of these disparities is the story of “Jackie,” a 52-year-old African American woman from Jackson. Jackie delayed seeking treatment for symptoms including leg swelling, cramps, nausea, and vomiting, largely due to fear of hospitalization and losing wages. When she eventually lost her job—and her insurance—she was diagnosed with kidney and heart disease.
Due to financial constraints, Jackie frequently skipped dialysis sessions and had no reliable transportation to appointments. Tragically, she passed away at home from complications linked to uncontrolled hypertension.
This heartbreaking story demonstrates how systemic barriers, lack of affordable coverage, and insufficient community resources contribute directly to preventable deaths in marginalized populations.
Addressing the health inequities in Jackson requires interventions that target both healthcare access and the broader social determinants of health.
Issues, Impacts, and Proposed Interventions
| Issue Identified | Impact on Community | Proposed Intervention |
|---|---|---|
| Lack of affordable insurance | Delayed/avoided care; worsening chronic illness | Expand Medicaid; offer subsidies for adults without dependents |
| Poor health literacy | Mismanagement of chronic diseases | Establish community health workshops and culturally tailored educational programs |
| Economic instability | Limited access to medications, healthy food, and exercise | Provide job training programs; include community health workers for outreach |
| Structural racism in healthcare | Disparities in diagnosis and treatment | Mandate implicit bias and cultural competency training for providers |
| Limited preventive care access | High rates of late-stage disease detection | Offer community-based hypertension and cardiovascular screenings at low or no cost |
Evidence shows that the integration of community health workers into healthcare teams not only improves hypertension control but also reduces overall cardiovascular risk (Williams & Cooper, 2019). Addressing health literacy, employment opportunities, and insurance coverage simultaneously builds a sustainable foundation for health equity.
The Mississippi State Department of Health is encouraged to prioritize policies and resources that will:
Expand access to affordable health insurance, especially for childless adults.
Invest in community-based health services that involve residents in decision-making.
Strengthen collaboration between social service providers and healthcare systems for holistic care.
Increase preventive health services, including free or subsidized cardiovascular and hypertension screenings.
Integrate community health workers (CHWs) into care teams to improve patient engagement and outcomes.
Address structural racism in healthcare through cultural competency training and equity-driven policies.
Support Medicaid reform and advocacy to close gaps in access.
I respectfully seek the opportunity to collaborate with the Mississippi State Department of Health in the following ways:
Designing and implementing health education programs tailored to underserved populations.
Establishing mobile clinics and community screening initiatives to improve early detection.
Launching a 12-month pilot intervention project, followed by evaluation and surveys to assess community impact.
By uniting stakeholders, providers, and policymakers, Mississippi can make significant strides in reducing health inequities and ensuring that African Americans in Jackson receive quality care and dignity in treatment.
Thank you sincerely for your dedication to improving health outcomes for disadvantaged populations. Please do not hesitate to reach out for further collaboration.
Sincerely,
Angelica Waller, MSN, BSN, RN
Chelak, K., & Chakole, S. (2023). The role of social determinants of health in promoting health equality: A narrative review. Cureus. https://doi.org/10.7759/cureus.33425
Ercia, A. (2021). The impact of the Affordable Care Act on patient coverage and access to care: Perspectives from FQHC administrators in Arizona, California and Texas. BMC Health Services Research, 21(1). https://doi.org/10.1186/s12913-021-06961-9
Erlangga, D., Suhreke, M., Ali, S., & Bloor, K. (2019). The impact of public health insurance on health care utilization, financial protection, and health status in low- and middle-income countries: A systematic review. PLOS One, 14(8), e0219731. https://doi.org/10.1371/journal.pone.0219731
Jurns, C. (2019). Using SBAR to communicate with policymakers. Online Journal of Issues in Nursing, 24(1), 13. https://doi.org/10.3912/OJIN.Vol24No01PPT47
McCoy, M. (2024, February 22). Mississippi has the 2nd-highest heart disease mortality rate in the US. WJTV 12 News. https://www.wjtv.com/living-local/focused-on-health/mississippi-has-2nd-highest-heartdisease-mortality-rate-in-us/
Raphael, J., & Rudowitz, R. (2024, March 12). A closer look at Medicaid expansion efforts in Mississippi. KFF. https://www.kff.org/policy-watch/a-closer-look-at-medicaidexpansion-efforts-in-mississippi/
Williams, D. R., & Cooper, L. A. (2019). Reducing racial inequities in health: Using what we already know to take action. International Journal of Environmental Research and Public Health, 16(4), 606. https://doi.org/10.3390/ijerph16040606
