Name
Capella University
NURS-FPX 4060 Practicing in the Community to Improve Population Health
Prof. Name
Date
High blood pressure, or hypertension, is a global health concern. According to the World Health Organization (WHO), it affects over 1.28 billion people worldwide, with a substantial burden in developed and developing countries (World Health Organization, 2023). In the United States alone, approximately 48.1% of adults have hypertension, making it a primary factor in cardiovascular illnesses, stroke, and premature death (Centers for Disease Control and Prevention, 2021). Several risk factors contribute to the development of hypertension. Modifiable risk factors include unhealthy diet (high in sodium, low in fruits and vegetables), sedentary lifestyle, tobacco use, excessive alcohol consumption, and stress. Non-modifiable risk factors encompass age, genetics, family history, and certain underlying medical conditions.
The consequences of hypertension extend beyond individual health, impacting communities and healthcare systems. It leads to a significant economic burden due to healthcare costs and productivity losses. According to the Centers for Disease Control and Prevention (2021), about $ 131 billion is spent annually tackling hypertension. Moreover, hypertension exacerbates health inequities, disproportionately affecting marginalized populations due to socioeconomic factors, access to healthcare, and cultural barriers. The analysis is based on several assumptions, including that the WHO and CDC provide authentic information on hypertension and its prevalence, which must be considered to promote health by managing blood pressure in the normal range. Additionally, it is assumed that hypertension is a chronic disease that can be managed by lifestyle modifications and adjusting modifiable risk factors.
Hypertension poses a significant health concern in California, as in many other regions worldwide. Its prevalence is noteworthy due to its association with various major health issues, such as kidney damage, heart disease, stroke, and other vascular issues. About 27.9% of adults in California have been diagnosed with high blood pressure (America’s Health Rankings, n.d.). This statistic places California at rank 3 among states regarding the percentage of adults diagnosed with hypertension (America’s Health Rankings, n.d.).
Additionally, socio-economic determinants such as income inequality, housing instability, and employment status intersect with hypertension outcomes, with individuals from lower-income communities experiencing higher rates of uncontrolled hypertension and related complications. Furthermore, California’s diverse population presents linguistic and cultural barriers to healthcare access and adherence to hypertension management guidelines (McIntire et al., 2021). Language diversity, particularly among immigrant communities, poses challenges in delivering culturally competent care and health education, hindering effective communication and treatment adherence. Additionally, disparities in health insurance coverage and healthcare access persist, particularly among Hispanic immigrants and low-income individuals, further impeding timely diagnosis, treatment, and management of hypertension. The prevalence of hypertension among Hispanics in California was found to be 24 % due to multiple cultural and socioeconomic barriers (McIntire et al., 2021).
Juan, a 45-year-old Hispanic man of Mexican descent residing in Los Angeles, California, faces hypertension amidst financial constraints and job-related stress as a construction worker. Despite being physically active due to his job, Juan’s diet consists primarily of convenience foods high in sodium and processed sugars. He has a family history of hypertension and has recently been diagnosed with the condition during a routine check-up at a community health clinic.
Limited access to culturally competent healthcare services exacerbates his challenges in managing his condition. Despite his family’s support, Juan experiences stress and anxiety about his health condition, worrying about the potential impact on his ability to provide for his family and maintain his job. As a representative of a demographic group disproportionately affected by cardiovascular diseases, tailored health promotion efforts are crucial to address Juan’s unique needs. This plan should emphasize culturally appropriate dietary recommendations, affordable healthcare access, and stress management strategies within the California population.
In collaboration with Juan, the following three Specific, Measurable, Attainable, Relevant, and Time-Bound (SMART) goals were developed:
Juan will reduce his intake of convenience foods high in sodium and processed sugars by tracking his daily food intake and aiming to replace at least two processed meals per week with fresh, whole foods (Specific, Measurable). This is achieved through collaboration with a nutritionist or community health educator to develop a personalized meal plan that fits his budget and cultural preferences (Attainable). By improving his diet, Juan can lower his blood pressure to normal, curtail the risk associated with complications due to hypertension, and enhance overall health and well-being (Relevant) (Verma et al., 2021). He will achieve a 20% reduced processed food consumption within six months, as measured by his food diary (Time-bound).
Juan will incorporate regular physical activity into his daily routine by aiming to engage in at least 30 minutes (Measurable) of moderate-intensity exercise, such as brisk walking five days a week (Specific). This is achieved by identifying opportunities to be active during work breaks, weekends, or family outings and integrating exercise into daily life (Attainable). Frequent exercise can enhance cardiovascular health, lower blood pressure, and lessen stress levels, supporting Juan’s hypertension management goals (Relevant) (Cleven et al., 2020). He will establish this routine within three months, gradually increasing the duration and intensity of workouts over time (Time-bound).
Juan will learn and implement stress management techniques to cope with job-related stressors by practicing mindfulness meditation or deep breathing exercises (Specific) for at least 10 minutes daily (Measurable). This will be achieved by attending stress management workshops or accessing online resources for effective coping strategies (Attainable). Managing stress is crucial for Juan’s overall well-being and hypertension management, as high blood pressure can be a result of ongoing stress. (Relevant) (Conversano et al., 2021). He will incorporate stress management techniques into his daily routine within one month, with ongoing practice and reinforcement to maintain these skills over time (Time-bound).
In conclusion, addressing hypertension as a community health concern requires a multifaceted approach, considering epidemiological data, socioeconomic determinants, and cultural factors. Juan’s case illustrates the importance of tailored health promotion efforts, such as SMART goals focused on dietary improvements, physical activity, and stress management. By collaborating across healthcare, community, and policy sectors, we can implement effective interventions to reduce health disparities and enhance population health outcomes for individuals like Juan living with hypertension in California.
America’s Health Rankings. (n.d.). Explore high blood pressure in california | AHR. America’s Health Rankings. https://www.americashealthrankings.org/explore/measures/Hypertension/CA
Centers for Disease Control and Prevention. (2021). Facts about hypertension. CDC. https://www.cdc.gov/bloodpressure/facts.htm
Cleven, L., Krell-Roesch, J., Nigg, C. R., & Woll, A. (2020). The association between physical activity with incident obesity, coronary heart disease, diabetes and hypertension in adults: A systematic review of longitudinal studies published after 2012. BMC Public Health, 20(1). https://doi.org/10.1186/s12889-020-08715-4
Conversano, C., Orrù, G., Pozza, A., Miccoli, M., Ciacchini, R., Marchi, L., & Gemignani, A. (2021). Is mindfulness-based stress reduction effective for people with hypertension? A systematic review and meta-analysis of 30 years of evidence. International Journal of Environmental Research and Public Health, 18(6), 2882. https://doi.org/10.3390/ijerph18062882
McIntire, R. K., Scalzo, L., Doran, C., Bucher, K., & Juon, H.-S. (2021). Acculturation and hypertension diagnoses among Hispanics in California. Journal of Racial and Ethnic Health Disparities. https://doi.org/10.1007/s40615-021-01033-4
Verma, N., Rastogi, S., Chia, Y., Siddique, S., Turana, Y., Cheng, H., Sogunuru, G. P., Tay, J. C., Teo, B. W., Wang, T., TSOI, K. K. F., & Kario, K. (2021). Non‐pharmacological management of hypertension. The Journal of Clinical Hypertension, 23(7). https://doi.org/10.1111/jch.14236
World Health Organization. (2023, March 16). Hypertension. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/hypertension
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