The National Center for Health Statistics (NCHS ), says that for every dollar used in health care, less than $0.03 is spent in health prevention activities. Community and public health nurses are in position to actively participate in health promotion. This article will describe the terms community and aggregate, and the differences between these concepts. The author will identify an aggregate and describe it as a health issue. The second part will illustrate the three stages of a conceptual framework and the application as an advocate for the aggregate.
A community is determined by the same rules, guidelines, and governmental laws. There are different types of communities: Geographic communities (same neighborhood, suburb, or city). Equally important is the community determine by culture, which includes the ethnics and religious groups, and disable, or fragile age people. The community includes several organizations and politic associations (Messing, 2009).
Is a group of individuals, families, and groups who are associated because of similar social, personal, health care, or other needs? Elders with depression within a society are an imperative aggregate in the community. The aggregate make up a community (Miller & Keane, 2009).
Differences between Aggregate and Community
When several aggregate are joined, it forms a whole. The aggregates are types of communities, and the communities are types of aggregates. Both aggregates and communities are considered as a whole, but the aggregate is on a larger scale than a community. Moreover, the aggregates can be up of communities (Miller & Keane, 2009).
Identification and Description of Aggregate
Depression is a crucial public health problem and a frequent mental disorder found in elderly people. Elders are at an incredibly high risk of depression because more than 50% of older adults suffer two or more chronic health condition. By 2015, adults age 65 and older will increase up to about 20% of the population in America; and by 2050, the population more than 85 is expected to reach 19 million (U. S. Census Bureau’s, 2010). Depressed elders have the highest rates of suicide as compared to any other age group. The five percent of adult older suffer of depression and a high incidence of suicide is reported in this population (Naegle, 2011). In 2004, every 100,000 people age 65 and older, 14.3 died due to suicide. This is higher than the rate of about 11 per 100,000 in the general population.
The statistics of depression are rapidly increasing in this population, and it is vital to identify the risk factors and implement actions to reduce these indicators (CDC, 2010). In Miami Dade County older Hispanic men who live alone reported to having the highest levels of depression. Other risk factors also are associated, such as physical disability, lack of family and social support, chronic diseases, or cancer (Russell & Taylor, 2009). In long-term care settings the percentage of residents with depression (9%) is less than the Florida (10%) and national average (15%). Identifying depression can be difficult in elderly people because the signs may be confused with the aging process, the medication’s side effect, and some medical conditions (Hospital Compare, 2010).
Christoffel’s Three Stages of a Conceptual Framework
This conceptual framework of Christoffel’s occurs in three stages (information, strategy, and action).The information stage includes the collection, description, and identification of data. The patterns of occurrence, risk, and defensive factors, effectiveness of the program in each level of prevention, and barriers to implement public health programs are just as important in this stage. The results of this stage are materialized as data reports, journal articles, and other information’s tools (Stanhope & Lancaster, 2010). The strategy stage is aimed at the distribution and gathering of information to identify what must be changed. This involves the information to professionals and lay audiences, describing short term goals, building coalitions, and disseminates these aspects. The results of this stage include policy report, campaigns and public education, press conferences, strategy meetings, and other methods of information. The action stage explains the application of methods for example rising founds, the work with the organizations (local and government), and changes of individual and social patterns.
The results of this stage include changes in attitudes, resource allocation; increase the social relations, policies, and procedures, which improve the positive results in public health (Stanhope & Lancaster, 2010). Christoffel’s Stages as Advocate in Older Adults with Depression The first stage (information stage) recognizes the problem: Older adults who are at a high risk of depression because they are associated with the incidences of chronic health conditions of the elderly population. The highest rates of suicide are reported in this age group. Every 100,000 people age 65 and older, 14.3 died by suicide in 2004. This is higher than the rate of about 11 per 100,000 in the general population (CDC, 2010). Miami Dade County has higher levels of depression reported in Hispanic men. Many risk factors are related to physical disability, lack of family and social support, and chronic diseases (Russell & Taylor, 2009).
Furthermore, depression in older adults is frequently misdiagnosed and undertreated. One of the most imperative barriers to achieve competent effectiveness is the lack of nursing’s knowledge to assess depression in older adults. Moreover, frequent misdiagnosis due to fact that the signs and symptoms of depression are confused with the aging process, medication’s side effect, and some medical conditions (Hospital Compare, 2010). The second stage (strategy stage) contains the creation of short-term and a time frame goal is the first step to achieve the objectives of the project. This project includes numerous activities to implement new changes in this public health area. The dissemination of data throughout public forums (newspapers, magazines, websites, radio, and television) is vital in awakening the public’s attention on this issue. The creation of an association with the different stakeholders (patients, family, health care providers, insurance companies, and other social institutions) is equally as important.
Lastly, it is absolutely necessary to contact local governments, community services, and voluntary organizations to organize coalition to work in this issue. The third stage (action stage) is focused on the application of the strategies such as participations in local radio, television, and publishing articles in the local newspapers to disseminate the action plan. The implementation of an educational program focused on patients, families, and health care professionals is an important step in this stage. The educational program aimed at the health care professionals (nurses, social workers, and other professionals) should be supported by evidence-based results. The Geriatric Depression Scale (GDS) will be used in this project; it is a proficient tool needed to assess depression in older adults. The National Aging Services will be contacted by the writer to obtain knowledge and support through the creation and implementation of the project.
Finally to achieve the objectives it is imperative to create a multidisciplinary teamwork in the county to obtain an adequate social interaction, regulations, and legislation that permits the reduction of the asperity of this public health problem in Miami Dade County. To conclude this article demonstrated the traits of aggregate and community. This paper also characterized the Christoffel’s stages and how each stage can be applied to elders with depression. Thus, an action plan was established to improve the quality of care in this vulnerable population in Miami Dade County was described.
American Psychological Association. (2011). www.apa.org. Retrieved from http://www.apa.org/pi/aging/resources/guides/depression.aspx Centers for Disease Control and Prevention. (2011). www.cdc.gov. Retrieved from http://www.CDS.gov/aging/mentalhealth/depression
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National Center for Health Statistics. (2009). Nursing Home residents 65 years of age and over by age, sex, and race: Health United States 2009, tab 105. Nies, M. A. & Mc Even, M. (2011). Community/Public health nursing: Promoting the health of populations (5th ed.). St. Louis, MO: Elsevier/Saunders.
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Retrieve from http://www.http//2010.census.gov/news/releases/operations/cb11-cn147thml
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