Improving Public Health Through Promotion Of High-Quality Healthcare For Socially Disadvantaged Groups In The United States

Background Literature

The primary objective of the project proposal is to improve public health through promotional activities towards access and equitable distribution of health care services for socially disadvantaged groups in the United States.

• To achieve the overall objective of the project and contribute to the effective achievement of the project objective, the project will also aim to achieve the following specific objectives for the socially disadvantaged groups;
• To promote equitable distribution of quality healthcare systems to the socially disadvantaged groups and especially those living in vulnerable conditions
• To promote equity in access to quality health care services for the socially disadvantaged groups without discrimination based on the economic and social status
• To promote the alignment of primary health care needs towards the identified needs for the homeless, the people living with a disability, the poor as well as the elderly population
• To promote the reduction of health disparities between the wealthy and the socially disadvantaged groups through the development of effective universal health care systems with a special focus on community-based healthcare systems
• To link up with various healthcare organizations dealing with disability groups, homeless groups, the elderly groups and community development groups towards integrative efforts to promote high-quality health care for these groups
• To empower the community-based health care facilities and systems towards the provision of quality health care services and reduce the barriers to primary health care for the socially disadvantaged groups in the community.

Substantial evidence provides that health promotion activities and programs have continuously benefited the people who are already most socioeconomically advantaged at the expense of the socially and economically disadvantaged groups (Brownson, Deshpande & Gillespie, 2017). As result health, inequalities and disparities have continued to increase leading to poor health care services to the socially disadvantaged groups. Residents living in communities or areas which are socially and economically disadvantage locations such as the homeless and the poor people in different communities (Doyle, Ward & Early, 2018). The elderly have been left in the care of their families’ despite the increasing chronic diseases reported among elderly people while others have been taken to health care facilities for the elderly. Access to these healthcare facilities has not been effective while the distribution of the healthcare facilities for the elderly has not been equitably done. The poor have been marginalized in terms of access to quality healthcare with the services provided catering for their primary health care needs due to increased costs of health care services and lack of equitable distribution of universal healthcare programs (Stafford & Wood, 2017). According to the World Health Organization, equity in healthcare distribution is a primary goal in global, national as well as local health care systems. Despite these efforts and policies, high and quality health care inequalities related so socioeconomic status has persisted between countries as well as within countries.

However, successful grant programs have been found to contribute to effective improvement in healthcare systems for different affected groups (Eldredge et al., 2016). Such programs include the Community Access to Child Health (CATCH)  Program and the Health Tomorrows Partnership for children program have been very effective in improving public health care promotion for children globally and especially from families living in marginalized areas (Sklar & Messer, 2018). The Community Access to Child Health program over the history has been very effective in supporting pediatricians who engage with the community to contribute to improved child health care. Through this public health promotion program for child health, they have been able to improve access to health care for children as well as promote advocacy for child public health through small seed grants (Wu et al., 2018). The Healthy Tomorrows Partnership for children program has also been very effective in supporting community-based health care services for children. The program has been effective in improving the health status of children as well as families and other underserved communities (Bollard, Mcleod & Dolan, 2018). The program has been working in line with Health Resources and Services (HRSA) goals which are focused on improving access to quality healthcare services as well as improving health equity and building healthier communities. The success was however made possible through a partnership with local pediatricians and community leaders.

Analysis of Health Problem

The analysis of the success of the above program shows that with well-developed programs and collective partnerships with appropriate bodies or organizations it is possible to promote high-quality health care for socially disadvantaged groups.  According to a research done by Kuper, Smythe & Duttine, 2018 provides that Universal health coverage policy has been adopted by many countries as a 2030 national target. Their research has emphasized the need to include health care needs for people living with a disability. It is based on a report provided by the World Health Organization arguing that people living with disability make up 15% of the world population and is more vulnerable to poor health (McCormack, Thomas, Lewis & Rudd, 2017). The report also provides that out of the 1 Billion people estimated globally to be living with a disability, 80% of the group live in low and middle-income countries with the majority likely to be poor and unable to access quality healthcare. The report also provides that these people are continued to face a broad range of social exclusion mostly in school, social engagements as well as in employment. Such exclusion deprives them with an opportunity to empower themselves economically to access quality healthcare (Kelfve, 2017).  Hence improvement of public health care through the promotion of high-quality health care or the socially disadvantaged groups will see the health care needs of the people living with disability met and access to quality healthcare improved.

For many years public health promotion activities have neglected health care needs for the elderly people. According to a research done by Golinowska, Groot, Baji & Pavlova, (2016), attributes the increased health care concerns among the elderly people in society as well as increased loneliness and social isolation to the lack of effective elderly health care promotion programs. Their findings also provided that the increased chronic conditions among elderly people have also resulted to lack of effective health care promotion programs aimed at improving the health status of the elderly in the modern society (Coll-Planas et al., 2017). The common problem with some of the existing programs which have affected their success in promoting high and quality health care among the elderly who are socially disadvantaged has been lack of sustainable sources of funding. We believe through this funding we will be able to achieve our health promotion objectives (Latulippe, Hamel & Giroux, 2017). There is, therefore, a need to promote health promotion activities among elderly people through the development of effective programs. This project seeks therefore to integrate the needs of the elderly people in the community under the socially disadvantaged groups needs to promote the development of health policies which will enhance and improve the quality and access of quality healthcare as well as through equitable distribution of health care systems for the elderly to the socially underserved groups in the society.

Context of Proposed Intervention

The action plan for the public health seeks to promote high and quality health care for the socially disadvantaged groups (the poor, the disabled, the elderly and the Homeless) in the society. Major emphasis on the action plan is on a partnership with the various organizations and stakeholders in community health care in improving the quality, access, and equity of health care services for socially disadvantaged groups.

Step 1: Build partnership with organizations engaged in homeless, elderly, disability and vulnerable groups in the society

Step 2:  Improve literacy on the importance of high-quality care for socially disadvantaged groups in the society

Step 3: strengthen the prevention of common medical conditions through engagement with community health care in charge of the socially disadvantaged group

Step 4: improve public health promotion skills among the community health workforce to enable quality health services delivery

Step 5: improve population data on public health promotion for socially disadvantaged groups and enhance the promotion of socially disadvantaged population health research

Step 6: continuous monitoring and evaluation of the program to improve efficiency and promote sustainability efforts of the program

Step 7: Promote the development and inclusivity of socially disadvantaged groups in universal health care coverage plans

Therefore the overall action plan is built on establishing strong partnerships with various stakeholders in public health and especially with the organizations tasked with the responsibility of improving health care for socially disadvantaged groups. The plan will ensure improvement in the distribution of health care services for socially disadvantaged groups, improve access and promote equity.

Anticipated Outcome	Significance
Strong partnerships with various health stakeholders	Improved need assessment and support for health care needs for socially disadvantaged groups Increased focus of quality health care services Increased focus of patients health preferences
Increased awareness on promotion of quality health for socially disadvantaged group	To reduce the increased illiteracy among community members on health rights for socially disadvantaged groups
Increased skills and competence among health care practitioners in meeting the health needs of the socially disadvantaged groups	Improved quality of the health services provided to the socially disadvantaged groups
Increased collaboration with communities to advance health promotion campaign	Increased sustainability of the health promotion even after the project timeline through the community stakeholders
Increased research on health care disparities and inequalities amongst the socially disadvantaged groups	To establish the health needs for socially disadvantaged groups and develop appropriate policies to address their health needs
Increased effectiveness of the program in improving the quality of health care needs of socially disadvantaged groups through effective monitoring and evaluation	Learn from the previous mistakes from similar projects and reduce the risk of failure
Inclusivity of socially disadvantaged groups into the national universal health care and coverage policies for 2030	Reduce social exclusion of socially disadvantaged groups from government health care budgets and policies

 

Evaluation of the health promotion of high-quality health for socially disadvantaged groups in society is important in ensuring that the program is able to optimize the set objectives (Fitzpatrick et al., 2015). The critical elements that will be examined to define the success of the health promotion program will be increased health literacy among the socially disadvantaged groups as well as the implementation of healthy public policies and organizational practices aimed at improving the quality and access to healthcare systems among the socioeconomically challenged groups (Hagen, 2018). The success is also defined through increased social action and influence that will contribute to increased community participation, empowerment as well as improved social norms and public opinion on health care for socially disadvantaged groups (Pickard & Ingersoll, 2016). The public health policies and organization practices outcomes will be measured or evaluated on the basis of their effectiveness in the implementation of policy statements, legislation, and resource allocation as well as increased support to organizational healthcare practices.

Intervention Goals and Objectives

The evaluation process for the health promotion program will involve three primary levels including; process evaluation, impact evaluation and outcome evaluation.

Process evaluation – the evaluation will be focused on the health promotion actions or activities, the coverage, quality, and the capacity building process through effective partnerships towards effective health promotion. Program reach/coverage and capacity building indicators will be used to measure the efficiency of the process in meeting the desired outcomes (Arpey, Gaglioti & Rosenbaum, 2017). Partnerships will also be used to evaluate the promotion effectiveness as key partnerships will influence the success of the program. 70% will be used as an indicator of the process effectiveness in meeting the healthcare needs for socially disadvantaged groups.

Impact evaluation – this will contribute to the determination of the immediate effect through which the health promotion program bears on the target groups as well as stakeholders. The impact evaluation will seek to establish the performance indicators on improved health knowledge and increased changes to health actions and practices as supported by Kim and Nahar (2018). It will also address the creation of new organizations and programs to promote health care needs of the socially disadvantaged groups as well as improved organizational policies and practices in support of health care needs for socially disadvantaged groups (Frankish, Kwan, Gray, Simpson & Jetha, 2017). 75% will be used as the indicator for the target group and will be used to assess the effectiveness of program intervention.

Outcome evaluation strategy- the ultimate goal of the health promotion program is to improve health outcomes for the socially disadvantaged groups in the community (Grahame et al, 2018). The health outcomes to be evaluated include; the quality of life, equity in the distribution of health care needs as well as improved access to quality healthcare services (Stepanikova & Oates, 2017). To measure the effectiveness of the health promotion program, 70% is the best indicator for evaluation of the above three outcome measures.

To achieve and meet the primary objective as well as the specific objectives of this public health promotion action, two and half years have been considered to be appropriated to deliver the expected health outcomes.

Activity	Proposed Duration	Completion Timeline
Conducting a target population health need assessment	5 months	January 2019 to May 30th 2019
Developing a marketing plan for the health promotion program	1 month	1st of June to end of June 2019
Data Collection and Review against the health promotion objectives and need assessment report	2 months	July 2019 to 30th August 2019
Developing the 1st draft of the Health promotion Budget	1 month	1st of September to the End of September 2019
Developing partnerships with various stakeholders as well as recruiting new members to the program	3 months	October 2019 to 30th December 2019
Resource Mobilization and Funding	2 months	January 2020 to 28th February 2020
Health promotion program implementation	1 year	March 2020 to march 2021
Monitoring and Evaluation of Program outcomes	2 months	April 2021 to  30th May 2021
Program effectiveness Implementation Report	1 month	1st June 2021 to 30th June 2021.

The Health promotion Program director Mrs. Jane Claudia will be responsible for overall coordination and supervision of all aspects of the health promotion.  She will be assisted by the health promotion program assistant director Mr. George Stevens. They will work in collaboration with other personnel and staff as well as in partnership with the various stakeholders in improving the quality of health for socially disadvantaged groups.

Strategies for Achieving Intervention Goals

References

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