User:Iyernikita/sandbox

Selecting Possible Articles

Area

https://en.wikipedia.org/wiki/Fruitvale,_Oakland,_California

https://en.wikipedia.org/wiki/Oakland,_California

https://en.wikipedia.org/wiki/East_Oakland,_Oakland,_California

Sector

https://en.wikipedia.org/wiki/Health_equity

https://en.wikipedia.org/wiki/Preventive_healthcare

https://en.wikipedia.org/wiki/Community_health

Evaluating Two Articles

Area

Article: https://en.wikipedia.org/wiki/Fruitvale,_Oakland,_California

In the brief history and summary of Fruitvale in the beginning of the article, there was a stark transition from the history to the shopping district that is currently present today. This transition, I believe, detracted from the intention of Fruitvale's identity. Furthermore, when looking at the history of Fruitvale in the history section, there was only a mention of a few organizations that were created during certain historical times periods and revolutions. However, there was no description or further elaboration on what these organizations' intentions were. On of the main avenues of this article that could contribute to a better understanding of my practice experience was looking more into the economic background and health issues that are prevalent within Fruitvale. There was no section in this article that regarded health issues and healthcare, except for the one sentence in the history section stating the establishment of La Clínica. Moreover, the economy section of Fruitvale also consisted solely of one line, listing only one group that operates within Fruitvale. Overall, there was a neutral point of view on describing the neighborhood of Fruitvale. However, one could argue that the previous writer was intended on portraying Fruitvale's continual renovation and upliftment into a modern city at present time, elaborating on the recent progress the neighborhood of Fruitvale has made. Checking the articles' links and citations, I found that many of them worked and appropriately linked up to the right information that corresponded to the citation in the article. By reading the article and then checking the citations chronologically with the article, I was able to connect the referred site and its information and how the previous author utilized that information to contribute to the neighborhood of Fruitvale. One thing I could also potentially add to the article was its relevance and contribution to the Oakland identity as well. Because Fruitvale is regarded as a neighborhood that is part of East Oakland, it could be informative to learn how Fruitvale fits in with the entirety of Oakland. Utilizing, paraphrasing, and citing links that correlate to the Oakland or East Oakland webpages could help achieve this. The majority of past conversations on the talk page have occurred over 3 months ago. The conversations covered the Jingletown section of the article and additional links and references that contribute to the site. I couldn't find the rating of the article Overall, based on my learning and understanding from my GPP class, I have found many holes that I could potentially look to fill in as part of my Wikipedia project. While the article as a whole regards Fruitvale in each avenue, there are many places in the article that doesn't touch up on a particular aspect of what encompasses the people of Fruitvale and might better understand the culture within Fruitvale compared to the rest of Oakland.

Sector

Article: https://en.wikipedia.org/wiki/Preventive_healthcare

This article regarding preventative healthcare looks into preventative healthcare and diseases that are currently prevalent on a global scale. The entire article covers the majority of what preventative healthcare encompasses. However, there are areas that could be enhanced in order to improve a better understanding. For the most part, this article is oriented to address mostly US issues. While it does include statistics on a global scale, the majority of the article covers health issues and disparities mainly present within the US. Something that could be further elaborated and discussed in this article that would be relevant to my practice experience would be displaying the demographics on a global scale about health issues that are preventable. Showcasing the common and most prevalent diseases and health issues among different countries and regions can help give an idea of the most common health issues and diseases that are present all around the world. Throughout the article, there are explanations regarding some of the more common preventable diseases. By recognizing possibly where the majority of the world population experience and are faced with this disease to also gain a better demographic understanding of where these diseases are most prevalent on the globe. Another thing that could be added into the article was a more thorough description of how the underlying causes to preventative diseases are exacerbated worldwide. In the section describing causes that contribute towards preventable diseases, only the statistical information was mentioned. However, more information and explanation regarding each cause can help attain a better understanding of how cause contribute towards disease. The citations and references listed throughout the article are very much relevant to the topic in the article. While going chronologically through the reading, each link correctly corresponded to the linked information. There is a growing bias towards gaining a better understanding within the US more so than the rest of the world. While the article does briefly discuss health issues on a global scale, the majority of the article describes prominent diseases and health issues that are present within the US, such as obesity and STIs. However, overall there is a neutral voice when addressing the various preventative diseases and health issues that are prevalent around the world. This article page keeps relatively up to date on the latest statistics and information regarding preventative health. With the most recent edit date being February 6th, 2018, this site is checked pretty regularly in order to maintain the appropriate and recent information and statistics about preventative health. This page has been the site for level4-vital article in Science, Biology, noting its accuracy in its statistics and information regarding preventative health. It is also involved in multiple WikiProjects, such as Medicine, Health and Fitness, Politics, and Education, reaching different areas and avenues to address preventative health and its relevance on many levels towards population and community health. Overall, this article correlates with my growing understanding and learning about global poverty and addressing global poverty from my GPP class through looking between the lines of preventative health and how it is rooted amongst different populations. By gaining a better understanding of preventative health, I can understand certain causes and resources that people may or may not have that can contribute to their increased risk in preventable disease. It helps me better understand the community as a whole and their understanding of health and health-related issues. By looking at preventative health from all angles, both globally, nationally, socially, politically, and economically, I can understand the effects of healthcare and how it influences the implementations of preventative measures to reduce disease risk within different parts of the world.

Bibliography

Area

Police-Recorded Crime and Perceived Stress among Patients with Type 2 Diabetes: the Diabetes Study of Northern California (DISTANCE) - scholarly peer-reviewed article - scholarly peer-reviewed article

This article studies a correlation between the crime rates and neighborhood crime and its stress on community health, specifically amongst patients with Type 2 Diabetes. He argues that while the initial study sought to find a pattern between these two aspects, they found no significant correlation. However, high crime rates may be disproportionately prevalent in neighborhoods with poorer health. The primary author, Aracely Tamayo, possibly studied this pattern as an effort to reach out to possible police forces, governmental agencies, and even health officials, with the intention to understand the significance between this correlation and make an effort to fix it. I read this article as a means to gain a better understanding of life within the present and surrounding area of my PE. I wanted to use this article as an introduction to learning more about where my practice experience is located and what kinds of patients my PE receives and what they encounter on a daily basis. This relates to my Wiki assignment by helping me preview and learn more about my practice experience and how I wanted to go about researching and writing about my area.

Exploring Equity in Multisector Community Health Partnerships - scholarly peer-reviewed article

This article analyzes Oakland specifically, looking into different components of health equity and how it contributed to overall community health. The head contributor, Darla Thompson, argues that through various partnerships throughout the community, there is increased engagement and collaboration towards improving health conditions and community health. In framing these partnerships, he portrays and analyzes community health within Oakland over recent years, how it has influenced people's daily lifestyles, and methods of improvement that have been implemented recently to elevate community health. Thompson targets both health organizations and officials to encourage increased partnerships throughout the community in order to facilitate a more collaborative effort in improving community health and health disparities. This article was useful in understanding East Bay's increased collaboration between organizations as a joint effort to improve overall health amongst the different communities. I used this paper to learn about the health conditions prevalent amongst the community as well as understand the deep-rooted history within health and healthcare in the East Bay and how it influenced the health disparities seen today. This article was useful for my Wiki assignment in previewing East Bay health and the efforts made to improve it.

Factors associated with substance use in older homeless adults: Results from the HOPE HOME study - scholarly peer-reviewed article

This study concludes that as the homeless population continues to grow and age over time, they continue to experience higher substance abuse than the general population, arguing for more mental health services and treatment programs be integrated into the community to improve overall community health, specifically within the older homeless population. Through understanding the factors associated with increased substance abuse, there is a better understanding for how to approach treatment programs and processes targeted towards the older homeless population. This study was localized within Oakland, creating a better representation of the population demographics. With regards to my practice experience, this can also be useful due to a high homeless population, which can significantly impact the overall community health. By understanding the factors associated with the increased risk, there can become a better understanding of how influential the community is in the increased substance abuse within the area. From my PE, as a community health clinic, we are faced with homeless individuals of all ages. Learning and understanding each population and age group helps us properly treat our patients that can improve their overall health, including mental health. This article helped me gain a better context for how I want to view my PE and area for the Wiki assignment. It helped me narrow down my interests surrounding my PE, i.e. Fruitvale or East Oakland, in order to thoroughly learn about the various populations of patients the clinic receives on a daily basis.

How do individual-level sociodemographics and neighbourhood-level characteristics influence residential location behaviour in the context of the food and built environment? Findings from 25 years of follow-up in the CARDIA Study - scholarly peer-reviewed article

This article focuses on how the neighborhood lifestyle influences many diet-related and health-related preferences and characteristics. Pasquale Rummo argues that neighborhood behavior is constantly influenced by the diet and activity-related amenities it is surrounded with, which can become influenced by socioeconomic factors. These relationships induce certain health behaviors among communities which lead to either better or poorer health. This study targets health officials as well as health organizations and food markets to identify this association and encourage greater accessibility towards a healthier diet. Therefore, though identifying this significant association, we can further understand the demographics within these regions, one of them being Oakland, CA. I believe that this study would help me gain a better understanding the behavioral lifestyle the representative group of Oakland has and how it influences their health and healthcare decisions. With my PE focusing specifically on community and preventative health, this helps me understand the relationship between food access and security as well as access to exercise, which influences their overall health. This concept of food security and access to diet- and activity-related amenities could be a possible section to include when discussing the health disparities in Oakland or East Oakland.

Food Security Status and Barriers to Fruit and Vegetable Consumption in Two Economically Deprived Communities of Oakland, California, 2013–2014 - scholarly peer-reviewed article

This article can help build off of another study I am currently analyzing through looking into preventative barriers towards fruit and vegetable consumption and food security. It argues that time constraints, cost, and taste all influence a population's ability to consume fruits and vegetables. This barrier prevents certain economically deprived communities from accessing healthier food groups, which can affect their ability to stay healthy. This article targets health officials as well as food markets in order to point out a population that is unable to consume healthy foods and therefore cannot take part in that particular marketplace, which eventually leads them to poorer health. This influences my PE, as it is focused on preventative and community health. Because nutrition is vital in preventative health and maintaining a proper diet in the body, it is continually encouraged to patients to eat properly. This article delves deeper into what prevents people from being able to eat healthy, regardless of their motivation to do right by their bodies. This article helped me understand food security within Oakland, possibly looking to create a section either within the Oakland or East Oakland Wikipedia pages elaborating on certain population's access to food and how that may influence their health conditions or disparities.

Tobacco cessation behaviors among older homeless adults: results from the HOPE HOME Study - scholarly peer-reviewed article

This study focuses mainly on tobacco behavior and mortality rates amongst the homeless population within Oakland, CA. It argues that despite the high mortality rates associated with tobacco amongst the homeless population, there was a similar rate in attempting to quit tobacco within the sample homeless population compared to that of the overall population, but a lower success rate within the homeless population in successfully quitting tobacco. It looks to highlight the opportunity for organizations and groups (target audience) to conduct treatment programs focusing on the older homeless population that can help improve this quitting success rate. I was looking to use this source as possibly a means to go into detail about the more common behavioral health issues that are prevalent within the community health in Oakland, as homelessness is highly prevalent in this region of the Bay. For my Wiki assignment, I was looking to focus it on this population as they primarily utilize the more affordable access to the healthcare clinics such as La Clínica. By understanding the factors associated with these high mortality rates and poorer health conditions we can look for more effective and preventable ways to improve tobacco-quitting rates among the older homeless population.

Building sustainable health and education partnerships: stories from local communities - scholarly peer-reviewed article

This source was useful for analyzing the relationship and correlation between health disparities prevalent among youth and their effects on academic achievements. It argues that with a significant negative association between health disparities and educational achievements, many school districts, including those within the City of Oakland, have made collaborative efforts to alleviate these disparities in order to improve academic achievements for students. This article targets school faculty, educational boards, and even health officials/organizations to collectively work on mitigating health disparities within students in order to help them academically succeed. With part of the study focusing on Oakland, CA, I was hoping to use this source to help embellish a new addition analyzing the various factors associated with the ongoing and increasing health disparities prevalent within Oakland, and how it may affect other aspects of people's lifestyles.

Income, Language, and Citizenship Status: Factors Affecting the Health Care Access and Utilization of Chinese Americans, Health & Social Work - scholarly peer-reviewed article

This article discusses the different factors associated with healthcare access and coverage amongst Asian Americans, specifically Chinese, within the US. Through analyzing the different levels of health coverage for Chinese Americans and the factors associated with it, the study finds that there are very limited resources given towards Chinese people in accessing healthcare resources. This is useful in gaining a general understanding of Asian Americans' access to healthcare relative to other races predominantly in Oakland. It also targets public and health officials in working together to provide accessible and usable healthcare towards Asian Americans, one that is culturally and linguistically appropriate while not discriminating against citizenship status. Understanding how diverse cultural and ethnic groups experience health disparities different contribute towards a greater understanding of how health coverage and access is distributed with the state and the nation, and how it influences health conditions and life expectancies across different races. It is important for my PE to help understand the level of access and care each group receives and the barriers they have towards accessing adequate care. This article is useful in my Wiki assignment in delineating the differences between ethnic groups based on various factors. It gives various tables and statistics showing health conditions, life expectancies, healthcare access, and healthcare coverage for Chinese Americans. This information is useful when comparing to other cultural and racial groups.

A Community-Based Collaboration to Assess and Improve Medical Insurance Status and Access to Health Care of Latino Children - scholarly-reviewed article

This article focuses on the assessing and improving access to health insurance and healthcare resources for Latin Americans and children, specifically within Oakland. Even though many Latino children are eligible for subsidized health insurance, this article argues that more community-based outreach and assistance should be given in order to provide these children with proper access to healthcare resources. This article encourages health insurance organizations and health officials to focus on this targeted population to help improve their healthcare access. Through understanding the current statistics and coverage prevalent in Northern California, it allows for a better comparison of Latino healthcare access to other racial groups also mainly prevalent in Oakland. This is important for my Wiki assignment as I want to compare the different cultural and racial groups prevalent within either Oakland or East Oakland in understanding their health disparities within the one region. These differences contribute to my PE because of the diversity of patients we receive in the community clinic (La Clínica), and how to best provide them with the necessary care and resources they need to stay healthy, despite their socioeconomic status or cultural background. This article can help compare with other racial groups on various factors that contribute to the health disparities prevalent within Oakland/East Oakland.

Poverty and Health Prospective Evidence From the Alameda County Study - scholarly-reviewed article

This article analyzes the socioeconomic and other factors associated with higher mortality rates amongst poverty areas compared to residents of non-poverty. It argues that there is a clear correlation between increasing socioeconomic status and lower mortality rates, which can be associated with other factors such as age, education, race, etc. These factors can create a clear picture of the health disparities within Alameda County and how they are influenced by different socioeconomic statuses and cultural backgrounds. The study targets public officials, health officials, and possibly each urban developers, who, understanding this relationship, can look to improve communities that consist of populations of lower socioeconomic status in order to lower the high mortality rates prevalent within these communities. This article contributes to my PE because of the diversity of patients we receive in La Clínica on different fronts, like socioeconomic status and cultural backgrounds. It helps to understand the population we work with and their level of access to healthcare, which can better improve how to care for our community in the best possible way. It also contributes to my Wiki assignment because I look to analyze the different socioeconomic backgrounds amongst various cultural/racial groups and how that might influence the care they receive or don't receive within Oakland or East Oakland. This then paints a picture of the health disparities prevalent within this region.

Community-Based Participatory Research: A Capacity-Building Approach for Policy Advocacy Aimed at Eliminating Health Disparities - scholarly-reviewed article

This article argues for increased community-academic partnerships in eliminating health disparities within Oakland, CA. The social and physical environment has created distinctions with healthcare between the rich and the poor as well as Whites and non-Whites. Because of this, the study argues for more policy changes that eliminate this socioeconomic and cultural gap within the population to make healthcare resources more accessible to the general population. This article targets healthcare officials and public policy officials in developing measures that can narrow the gap between those that can and cannot access healthcare. These divisions are what creates the rising health conditions and lowering life expectancies within certain populations that continue to grow over the years. I was interested in this article in gaining a better understanding of how the socioeconomic and cultural factors are associated with the widening gap of access to healthcare resources, as well as how that might influence the health disparities within these populations. I wanted to not only understand this for my PE when communicating with these diverse populations in improving their healthcare, but also to elaborate on these distinctions within East Oakland on my Wiki Assignment. I believe these distinctions are key towards understanding how the health disparities between racial groups maps out in these regions and its importance towards understanding their lifestyle.

2016 Community Health Needs Assessment - scholarly-reviewed article

This article analyzes the collaboration within Kaiser Permanente and other non-profit hospitals within the Alameda and Contra Costa Counties has implemented the Community Health Needs Assessment (CHNA) and how it has influenced the health conditions amongst different populations. It shows that there has been a significant improvement in addressing health conditions within these counties, displaying statistics and measures from community clinics to county hospitals. Through gathering this data, this assessment gained a further understanding of the community needs and how to prioritize these needs with diverse populations. This article targets both county health department, state health departments, county hospitals and community clinics in facilitating and addressing community health needs adequately and appropriately to their diverse patient population. Focusing specifically on Oakland, this article is useful for its analysis and assessment of the community itself and their current access to healthcare resources, as well as how that influences their community health needs. Utilizing the tables, maps, and breakdowns according to socioeconomic status and racial groups, I was able to understand the distinctions between certain populations and how that might display the health disparities accurately within Oakland and East Oakland. Furthermore, this helps understand my PE and how it also contributes towards addressing the community needs. La Clínica was also mentioned in this article, being one of the community health clinics in Oakland (East Oakland), and it highlighted its contributions towards improving community health. Through this article, it also helps develop a futuristic path for what goals my PE might have or will address in the future.

Realities of Medical Practices: Serving African Americans in East Oakland - scholarly-reviewed article

This article focuses on how health and healthcare disparities are still prevalent within a community even after recent policy changes like the Affordable Care Act (ACA). Through a thorough assessment of the entire community of Oakland, this article argues that limited number of organizations dedicated towards improving African Americans' access to healthcare must continue to be maintained and even expanded to fit the needs of the growing population in Oakland. It targets current organizations as well as rising healthcare organizations to address the lack of resources for African Americans to better access healthcare. This article is particularly useful when analyzing how healthcare resources influences racial health, particularly amongst African Americans when compared to other cultural groups. Using the tables and graphs they provided allowed me to compare the variability amongst cultural groups within Oakland on Wikipedia, and how that influences their life expectancy and health conditions. This article was useful for my PE because while I see primarily Latino/Chicano populations based on our location and history, we don't see a lot of African Americans in our clinics, which may indicate that we may not yet have the resources to provide them or they may not even know about the resources that we provide.

Alameda County Plan for Older Adults Fiscal Year 2016-2017

This document focuses primarily on the older adult population within Alameda County, arguing to reframe the structure of their healthcare services and community in integrating more resources for the elder population in order to better care for them. Written as a plan to incorporate a new framework in the current healthcare system, it illustrates the current lack or insufficient resources available for older adults, which compromises their life expectancy and health conditions. This article's audience looks to hospital managers, health and policy officials, and possibly even the general public to display their enhancement of the healthcare delivery system in appropriately providing for the growing elderly population. I sought to better understand these current limitations, understanding the current statistics of healthcare access and coverage on average compared to the rest of the population within Alameda County. These distinctions continue to illustrate the health demographics and disparities within the county, including Oakland/East Oakland and how that might affect that population, which is what I look to incorporate in my Wiki assignment. This is also useful for my PE, as it helps me understand the improvement in the care process at La Clínica when treating elderly patients.

CHIS Data

This page also focused on the elderly adult population, arguing for the growing demand for long-term healthcare services and affordable programs for older adults in order to better treat them. They primarily target healthcare providers, public policymakers, planners and advocates to develop a Health Disparities Program, which plans to spread awareness of this ongoing issue and address it at the local, state, and national level. This site was interesting when connecting it back to my practice experience, understanding the lack of resources that community health clinics have to address the elaborate needs to the elderly. With more support and policy, more assistance could potentially be given to this population. With regards to my Wiki assignment, this site adds a new layer of information in expanding on the elderly population in particular when addressing the different multitudes of health disparities prevalent within Alameda County, including East Oakland.

Mental Health in California: Painting a Picture

This article focused on the lack of adequate funding, attention, and resources allocated towards mental health in the state of California. As a very prominent issue in California, the publication provides statistics and general data on how common mental health patients go untreated, from children to adults. They target healthcare providers as well public policymakers in an effort to better fund and attend to mental health patients in giving them the care they need. This site helped me gain a general overview of mental health in California, and how little people pay attention to it. When looking at my PE, I rarely see mental health patients coming into the clinic looking for treatment, which might either mean that the clinic does not have the means and resources to care for these patients, or that these mental health patients are unaware of the services La Clínica provides for mental health. I was hoping to expand on mental health within East Oakland. However, I was not able to uncover a lot specific to East Oakland. While it was interesting to learn about mental health and I tried expanding on it in my contributions, there was very little to use.

Challenges to Mainstream Health Care in Oakland’s Underserved Communities

This article focuses on what hinders underserved populations from accessing healthcare. While it does briefly discuss the socioeconomic factors associated with healthcare access, it mainly elaborates on the linguistic, racial and cultural barriers that are experienced when utilizing healthcare. With lack of diversity and cultural awareness in the healthcare field, it makes communication and comfort difficult for minority populations to be able to utilize the health resources. This article targets healthcare professionals to expand on their patient care to incorporate minority groups in being able to access healthcare resources. This article brought another layer into healthcare access, especially when looking into diversity in East Oakland. When understanding what prevents people from going to the hospital or the clinic, it brings a new perspective into my PE, understanding its own limitations and where the clinic could potentially expand if it had the funding. For my Wiki assignment, I wanted to use this article to emphasize some of the barriers many minority populations experience in East Oakland when accessing healthcare.

Our Work: East Oakland Building Healthy Communities

This site discusses the current efforts, collaborations, and partnerships created in order to build happier and healthier communities within East Oakland. Through teamwork, various groups go out into the community to address the key cultural and racial barriers that prevent communities from accessing healthcare resources. Through health education and awareness, the East Oakland community has grown closer towards improving overall community health. This site targets the general public, primarily those within East Oakland and surrounding areas to observe the work that they are doing to improve healthy lifestyles in East Oakland. This site was useful to tie together the local improvements currently being made in response to the health disparities in East Oakland. It is also good to note for my PE to understand and be aware of all the other added efforts being made within the community in East Oakland to alleviate health disparities.

Sector

Integrating community-based health promotion programs and primary care: a mixed methods analysis of feasibility - scholarly peer-reviewed article

This article discusses the challenges and opportunities chronic disease self-management program encompass when integrated into the healthcare system. While he concludes that primary care and community-based care remain disconnected, the study argues that continued efforts should be made in integrating and collaborating preventative health measures into primary care, a level of care mainly given within community health clinics. With community health clinics primarily responsible for maintaining community health, this article helps contribute towards the effectiveness of chronic disease self-management programs and how it takes root in our healthcare system. With these programs quite prominent at La Clínica, this article provides a different perspective on its effectiveness when integrated into primary care. For my Wiki assignment, this article's perspective on the integration of chronic disease self-management programs into primary care helps add a new layer into the debate on its effectiveness and success.

Associations Between Community Sociodemographics and Performance in HEDIS Quality Measures: A Study of 22 Medical Centers in a Primary Care Network - scholarly peer-reviewed article

This article focuses on how provider and health plan payments can affect the quality of healthcare given to their patients, a measure that is most prevalent on a community health level. Studying this association with sociodemographic factors when comparing HEDIS quality measures, the study finds that sociodemographic factors prevalent within the studied area need to be taken into consideration when analyzing the quality of the performance at the primary care level. This focus evaluates and targets the healthcare managers who evaluate and measure healthcare quality, efficiency, and effectiveness throughout the US, wanting to consider the different social, demographic and economic factors that are prevalent within the studied region before any measurements. This study is relevant to my PE when discussing the quality of care given at the primary level, even within La Clínica. Understanding the community, the population, economic status, and geography can contribute towards provider performance and quality of care given. I was looking to discuss the effectiveness of quality of care measurements when evaluating community health in my Wikipedia assignments, as a way of understanding how people are measuring progress within community health.

Support and Sabotage: A Qualitative Study of Social Influences on Health Behaviors Among Rural Adults - scholarly peer-reviewed article

This source primarily focuses on how social factors can influence health behaviors that may result in health-related issues such as chronic diseases, an issue prevalent mainly in middle adults in rural areas. The study argues that gender roles may continue to play a role in health behaviors, putting most of the burden on lifestyle changes on the mother. In other words, the mother is usually in charge of initially this change in behavior in the lifestyle, which can influence health behaviors within the family. Overall, it targets rural families as well as health professionals in understanding the rural perspective in health behavior and their implications in health conditions, such as chronic disease. This allows them to develop ways to address and possibly alleviate the ongoing chronic health conditions rural populations face. While this article specifically might not bear much relevance to my practice experience since it is generally located in the suburban/urban atmosphere, the concept still applies: understanding the family/social dynamic can allow you to understand how to create behavior and lifestyle changes. For my Wiki assignment, I was thinking about using this article in elaborating on the social effects and dynamics that may influence community health.

Effect of a Self-Management Program on Patients with Chronic Disease - scholarly peer-reviewed article

This article analyzed the effectiveness of Chronic Disease self-management programs amongst people with chronic diseases, arguing that after one year, there are statistically significant improvements found in patient outcomes and conditions as well as reduced healthcare utilization. Henceforth, chronic disease self-management programs might be useful and effective in help treating patients while reducing healthcare costs, making it cost-effective as well. This article targets health clinics and other primary care facilities associated with chronic diseases, possibly encouraging the use of chronic disease self-management programs. This article helps contribute towards the effectiveness of chronic disease self-management programs and how it takes root in our healthcare system. With these programs quite prominent at La Clínica, this article provides a different perspective on its effectiveness when integrated into primary care and secondary prevention. For my Wiki assignment, this article's perspective on the integration of chronic disease self-management programs into primary care helps add a new layer into the debate on its effectiveness and success.

Evidence Suggesting That a Chronic Disease Self-Management Program Can Improve Health Status While Reducing Hospitalization: A Randomized Trial - scholarly-reviewed article

This article analyzed the effectiveness of Chronic Disease self-management programs amongst a mixed group of people with chronic diseases, arguing that after one year, there are statistically significant improvements found in patient outcomes and conditions as well as reduced healthcare utilization. Henceforth, chronic disease self-management programs might be useful and effective in help treating patients while reducing healthcare costs, making it cost-effective as well. This article targets health clinics and other primary care facilities associated with chronic diseases, possibly encouraging the use of chronic disease self-management programs. This article helps contribute towards the effectiveness of chronic disease self-management programs and how it takes root in our healthcare system. With these programs quite prominent at La Clínica, this article provides a different perspective on its effectiveness when integrated into primary care and secondary prevention. For my Wiki assignment, this article's perspective on the integration of chronic disease self-management programs into primary care helps add a new layer into the debate on its effectiveness and success.

Chronic Disease Self-Management Program: 2-Year Health Status and Health Care Utilization Outcomes - scholarly-reviewed article

This article provides yet another perspective on the effectiveness of chronic disease self-management programs, with a two-year followup on each of the studied patients for further analysis. It argues that after two years, there are statistically significant improvements found in patient outcomes and conditions as well as reduced healthcare utilization. Henceforth, chronic disease self-management programs might be useful and effective in help treating patients while reducing healthcare costs, making it cost-effective as well. This article targets health clinics and other primary care facilities associated with chronic diseases, possibly encouraging the use of chronic disease self-management programs. This article helps contribute towards the effectiveness of chronic disease self-management programs and how it takes root in our healthcare system. With these programs quite prominent at La Clínica, this article provides a different perspective on its effectiveness when integrated into primary care and secondary prevention. For my Wiki assignment, this article's perspective on the integration of chronic disease self-management programs into primary care helps add a new layer into the debate on its effectiveness and success.

Meta-Analysis: Chronic Disease Self-Management Programs for Older Adults - scholarly-reviewed article

This article studies the efficacy of chronic disease self-management programs for certain diseases like hypertension, diabetes, and osteoarthritis. The study argues that there are statistically significant improvements found in patient outcomes and conditions for diabetes and hypertension. However, there was no clinically significant data found to show improvement in patient outcomes such as pain and function in osteoarthritis. Henceforth, there is still some debate as to whether chronic disease self-management programs might be useful and effective in help treating patients while reducing healthcare costs. This article targets health clinics and other primary care facilities associated with chronic diseases, to possibly utilize the use of chronic disease self-management programs. This article helps contribute towards the effectiveness of chronic disease self-management programs and how it takes root in our healthcare system. With these programs quite prominent at La Clínica, this article provides a different perspective on its effectiveness when integrated into primary care and secondary prevention. For my Wiki assignment, this article's perspective on the integration of chronic disease self-management programs into primary care helps add a new layer into the debate on its effectiveness and success.

Chronic disease self-management education programs: challenges ahead - scholarly-reviewed article

This article focuses on the challenges faced with chronic disease self-management programs. While these programs might be beneficial according to recent studies, we must also consider the drawbacks and obstacles hindering it from its proper and complete implementation. Through understanding these concerns, we can thoroughly consider both sides of self-management programs. This article targets health clinics and other primary care facilities associated with chronic diseases, to consider both the challenges as well as the benefits of the chronic disease self-management program, and possibly to enhance the program to mitigate its challenges. This article was beneficial towards understanding not just the upside of chronic disease self-management programs, but also the downsides. This conflicting view adds towards the debate about their effectiveness when integrated into primary care, which contributes towards my Wiki assignment when discussing chronic disease self-management programs. It also relates back to my PE because when volunteering in the diabetes self-management programs, I can look out for those drawbacks and possibly try to find ways to fix them.

Self-management Education Programs in Chronic Disease: A Systematic Review and Methodological Critique of the Literature - scholarly-reviewed article

This article is composed of literature reviews and analysis of previous studies focusing on self-management programs, including chronic disease. By analyzing and comparing their effectiveness through a single study and evaluation under a uniform criteria, greater significance can be retrieved. However, there was very little clinical significance found to show improvement in patient outcomes for select chronic diseases. He encourages further trials be conducted to determine its effectiveness. Henceforth, there is still some debate as to whether chronic disease self-management programs might be useful and effective in help treating patients while reducing healthcare costs. This article targets health clinics and other primary care facilities associated with chronic diseases, to possibly utilize the use of chronic disease self-management programs. This article helps contribute towards the effectiveness of chronic disease self-management programs and how it takes root in our healthcare system. With these programs quite prominent at La Clínica, this article provides a different perspective on its effectiveness when integrated into primary care and secondary prevention. For my Wiki assignment, this article's perspective on the integration of chronic disease self-management programs into primary care helps add a new layer into the debate on its effectiveness and success.

Chronic Disease and Health Promotion

This site gives more insight into chronic diseases and its prevalence amongst the human population, arguing its severity and prominence especially within the US. It is useful in better understanding how chronic disease affects communities and healthcare costs, so we can develop ways to improve treatment and overall health amongst patients while making healthcare more affordable. This article targets a general audience, educating the public about the prevalence of chronic disease to emphasize its magnanimity in the US. This site is useful for my practice experience in gaining a general understanding of how common chronic diseases are and how much they cost to treat within the healthcare system. This insight makes me more imperative to treat within the community in order to prevent this ongoing epidemic within our nation. This site was useful for my Wiki assignment in defining what chronic diseases were and how prominent it has become over recent years.

Summarizing and Synthesizing/Describing What I Will Be Talking About

Area

East Oakland, California - Health Disparities

I will look to create a section within the Demographics Section labeled "Health Disparities," associating certain populations with the most common health conditions prevalent in the area and how each population within the community is affected by access to healthcare and their implications on their health conditions. Past epidemics and current epidemics that might be localized within the area could also be relevant towards better understanding the city of Oakland. The poverty population widely consists homelessness, those of which are 3 or 4 times more likely to use tobacco than the overall population. Amongst the older adult homeless population, tobacco usage accounts for nearly a quarter of overall mortality rates as well as half of substance-related mortalities, increasing health-related risks of chronic diseases such as chronic obstructive pulmonary disease and coronary heart disease. Furthermore, the spatial landscape in which Oakland orients itself in association to neighborhoods and their diet-related behavior is influencing not only their own health, but also their access to healthcare resources. Understanding how a community is laid out can help better understand how and what kinds of resources certain populations, namely the poverty population, have access to on a daily basis and how that may potentially influence their overall health. A study analyzing sociodemographics and characteristics associated with residential behavior noted that individual gender as well as neighborhood racial and age composition related to the structure of their environment and their access to the food around them, thereby impacting neighborhood health indirectly. Understanding how community health fits into the overall schema of Oakland, at the end, I can tie together how the community health influences other sectors of the community as well, such as education and economic improvement. According to a study analyzing the effects of health equity and education within Alameda Country Health Services Authority and Oakland Unified School District. The principle challenge within the district is children and families still living in low-opportunity neighborhoods, creating "long-term impacts on their health, education, and economic well being." "Compared to a Caucasian child in the affluent Oakland Hills, an African American born in West Oakland is 1.5 times more likely to be born premature or with low birth weight; 7 times more likely to be born into poverty; 4 times less likely to read at grade level; 5 times more likely to be hospitalized for diabetes, and twice as likely to die of heart disease. The life expectancy differential is 15 years." In recent years, health and educational institutions have been collaborating to improve local communities increasing life expectancy and improving access to educational opportunities for students.

Sector

Community Health - Primary Healthcare

Part of understanding community health is also evaluating the community's access to healthcare resources. One study analyzes the sociodemographic factors that contribute overall to a patient's or a community's access to healthcare. The "performance" of healthcare plans and physicians can influence the distribution of healthcare resources and who has access to it within a community. Such a factor, as well as others, should be noted when understanding how community health should be interpreted and analyzed. Many communities within the US also focus on implementing programs that work to eradicate certain chronic diseases within a population, such as diabetes. Self-management programs are effective primary healthcare tactics that are affordable and contribute to reducing overall community risk towards specific chronic diseases, which could potentially increase life expectancies as well within certain populations that are more at risk to these diseases. Incorporating both education and engagement within the community can increase community health and awareness overall, pushing them to make choices about their own health and their lifestyle. One aspect of understanding chronic diseases risk within a population is also studying the factors associated with this increased risk. One study analyzes on the social factors contributing towards higher rates of health-risk behaviors, such as tobacco use and poor diet. Some factors include age, gender, family interactions, and peer networks mainly contribute towards community behavior.

Outlines for Drafts/Summarizing and Synthesizing Part 2

Area

• analyzing East Oakland, CA
• looking to separate the sub-section under the Demographics section into Educational Attainment and Economic Income - looking to separate the two as a way to give more definition to economic income and how it contributes to healthcare access.
• I will also create a section labeled "Health Disparities"
  • Life Expectancies, categorized by race/ethnicity
  • Health Insurance
    • Adult vs Children
    • Race
      • Asian Americans
      • Whites
      • African Americans
      • Latin Americans
  • Healthcare Access
    • Statistics
    • ER visits
  • Socioeconomic Status (possibly expand in Economic Income in above section?)
    • Poverty
    • Contributes to Healthcare Access/Coverage?
  • Food Security?

Life Expectancy

East Oakland experiences a lower life expectancy, relative to nearby neighborhoods like Alameda County, approximating 72 years. Amongst the heavily populated races present within Oakland, Hispanics lead in life expectancy, averaging 82 years. African Americans and Whites typically average 67-68 years within Oakland, while Asians live nearly 78 years. Conversely, there is a high all-cause mortality rate amongst the East Oakland community, leading in cancer, stroke, heart disease, and homicide death rates. It is found that communities and families of lower socioeconomic status typically experience higher mortality rates and lower survival rates compared to those from higher socioeconomic status.

Life expectancies were calculated using survival curves analogous to those in Figure 1. The vertical height of each bar depicts the 95% confidence interval. The difference between expected age at death in the top and bottom income percentiles is 10.1 years (95% CI, 9.9–10.3 years) for women and 14.6 years (95% CI, 14.4–14.8 years) for men. To control for differences in life expectancies across racial and ethnic groups, race and ethnicity adjustments were calculated using data from the National Longitudinal Mortality Survey and estimates were re-weighted so that each income percentile bin has the same fraction of black, Hispanic, and Asian adults.

Health Conditions

East Oakland displays a significantly higher rate of common health conditions, with residents cumulatively experiencing 32% obesity, compared to 21% amongst all of California. Nearly 32% of adults in the community is at fair or poor health, relative to Alameda County's 15% and California's 16%. Similar patterns are also prevalent in children ages 0-17, with approximately 48% of children diagnosed with obesity, compared to 29% within the state of California. 13% of children in East Oakland also experience fair or poor health, a rate much higher than that of California (7%) or Alameda County (5%). Amongst older adults, due to increases in disabilities (accounting for 42% of disabilities), there is a greater onset of chronic diseases, accounting for 64% of deaths primarily in cancer, heart diseases, Alzheimer's, stroke, and respiratory diseases. As an effort to improve these existing conditions, East Oakland has become one of 14 different site across the state of California to participate in a 10-year comprehensive community initiative dedicated to improving and supporting a healthy community through active collaborations among youths, residents, and community partners within three Action Teams: Health Happens in Schools, Health Happens in Neighborhoods and Health Happens through Culture, Arts, Storytelling & Healing.

Healthcare Access

Adults in East Oakland are more likely to visit emergency rooms than go to doctor's visits within the past year than many other counties in the Bay Area and in the entire state of California. In 2012, 35% of the community did not meet with their doctor, resulting in approximately 30% of residents taking advantage of the emergency room, relative to 13% in Alameda County and 18% in all of California. Amongst all ER visits, Blacks and Hispanics had the most frequent visits in 2011, with four times more visits compared to whites and Asian/Pacific Islanders. Furthermore, even when having healthcare coverage, Blacks continue to be the highest users of the emergency department, with 15% enrolled in governmental programs whilst consisting of 43% of frequent ER users. Amongst elderly adults, rising numbers in disabilities have resulted in increased hospital emergency visits. Heart disease, leading in chronic diseases amongst elders, accounts for over 19,500 hospitalizations each year. However, racial, linguistic, cultural, and cost barriers continue to influence level of access amongst the population.

Healthcare Coverage

East Oakland ranks amongst the lowest communities to provide healthcare coverage to adults and children. 52% of adults and 40% of children remain insured by private insurance companies, compared to 61% and 57% coverage throughout the state of California. East Oakland residents are one of the higher users of governmental health programs like Medi-Cal and Medicare, covering 27% of adults and 58% of children in the population, almost 30% higher than that of California. In the elderly population, 98% of older adults within the entire Alameda County have health insurance. However, due to rising costs in medical care in recent decades, the California Health Interview Survey observed that 48.5% of adults age 60+ let go of their insurance coverage.

Amongst Hispanics, nearly 74% were enrolled in government health insurance, such as Medi-Cal and Healthy Families. Median income amongst enrolled Hispanic families is $16,800, whereas non-enrolled Hispanics receive a median annual income of $19,200. The average family household enrolled in health insurance amongst Hispanics is approximately 4-6 people.

Hospital/Health Care Facilities

East Oakland is home to Highland Hospital, UCSF Benioff Children's Hospital Oakland, Kaiser Permanente Oakland Medical Center, and Alta Bates Summit Medical Center. There is an abundance of health clinics also available in East Oakland, serving primarily low-income and underprivileged populations. Primary healthcare clinics include Roots Community Health Center, Lifelong Medical Care, La Clínica de la Raza, and East Oakland Health Center.

Mental Health

The Bay Area accounts for one of the lowest rates of mental illnesses throughout the state of California, rating at 7% of adults with SMI (serious mental illness) and 3.4% for children with SED (serious emotional disturbance). In recent decades, mental health expenditures have decreased within the state of California, spending nearly 8.2% between the years 1986-1992 to spending 6.4% between 2002-2005.

Sector

• analyzing Community Health
• looking to add a subsection in chronic disease self-management programs underneath Secondary Healthcare and Secondary Intervention
  • define what it is
  • what it looks to achieve
  • recent studies that analyzes its effectiveness and possible ineffectiveness (possible 2 each?)
  • explain its cost effectiveness

Chronic Disease Self-Management Programs

Chronic diseases has been a growing phenomena within recent decades, affecting nearly 50% of adults within the US in 2012. Such diseases include asthma, arthritis, diabetes, and hypertension. While they are not directly life-threatening, they place a significant burden on daily lives, affecting quality of life for the individual, their families, and the communities they live in, both socially and financially. Chronic diseases are responsible for an estimated 70% of healthcare expenditures within the US, spending nearly $650 billion dollars per year.

With steadily growing numbers, many community healthcare providers have developed self-management programs to assist patients in properly managing their own behavior as well as making adequate decisions about their lifestyle. Separate from clinical patient care, these programs are facilitated to further educate patients about their health conditions as a means to adopt health-promoting behaviors into their own lifestyle. Characteristics of these programs include:

• grouping patients with similar chronic diseases to discuss disease-related tasks and behaviors to improve overall health
• improving patient responsibility through daily disease-monitoring
• inexpensive and widely-known

Chronic Disease self-management programs are structured to help improve overall patient health and quality of life as well as utilize less healthcare resources, such as physician visits and emergency care. Furthermore, better self-monitoring skills can help patients effectively and efficiently make better use of healthcare professionals' time, which can result in better care. Many self-management programs either are conducted through a health professional or a peer diagnosed with a certain chronic disease trained by health professionals to conduct the program. No significant differences have been reported comparing the effectiveness of both peer-led versus professional led self-management programs.

The distribution of rural CDSME program participantsvaried across the US. Analysis across rurality indicated that approximately 22.1% (using county-level rurality) to24.4% (using ZCTA/ZIP Code-level rurality) of CDSME programparticipants resided in rural areas.

There has been a lot of debate regarding the effectiveness of these programs and how well they influence patient behavior and understanding their own health conditions. Some studies argue that self-management programs are effective in improving patient quality of life and decreasing healthcare expenditures and hospital visits. A 2001 study assessed health statuses through healthcare resource utilizations and self-management outcomes after 1 and 2 years to determine the effectiveness of chronic disease self-management programs. After analyzing 800 patients diagnosed with various types of chronic conditions, including heart disease, stroke, and arthritis, the study found that after the 2 years, there was a significant improvement in health status and fewer emergency room and physician visits (also significant after 1 year). They concluded that these low-cost self-management programs allowed for less healthcare utilization as well as an improvement in overall patient health. Another study in 2003 by the National Institute for Health Research analyzed a 7-week chronic disease self-management program in its cost-effectiveness and health efficacy within a population over 18 years of age experiencing one or more chronic diseases. They observed similar patterns, such as an improvement in health status, reduced number of visits to the emergency room and to physicians, shorter hospital visits. They also noticed that after measuring unit costs for both hospital stays ($1000) and emergency department visits ($100), the study found the overall savings after the self-management program resulted in nearly $489 per person. Lastly, a meta-analysis study in 2005 analyzed multiple chronic disease self-management programs focusing specifically on hypertension, osteoarthritis, and diabetes mellitus, comparing and contrasting different intervention groups. They concluded that self-management programs for both diabetes and hypertension produced clinically significant benefits to overall health.

On the other hand, there are a few studies measuring little significance of the effectiveness of chronic disease self-management programs. In the previous 2005 study in Australia, there was no clinical significance in the health benefits of osteoarthritis self-management programs and cost-effectiveness of all of these programs. Furthermore, in a 2004 literature review analyzing the variability of chronic disease self-management education programs by disease and their overlapping similarities, researchers found "small to moderate effects for selected chronic diseases," recommending further research being conducted.

Some programs are looking to integrate self-management programs into the traditional healthcare system, specifically primary care, as a way to incorporate behavioral improvements and decrease the increased patient visits with chronic diseases. However, they have argued that severe limitations hinder these programs from acting its full potential. Possible limitations of chronic disease self-management education programs include the following:

• underrepresentation of minority cultures within programs
• lack of medical/health professional (particularly primary care) involvement in self-management programs
• low profile of programs within community
• lack of adequate funding from federal/state government
• low participation of patients with chronic diseases in programs
• uncertainty of effectiveness/reliability of programs

My Contributions

Area (East Oakland, CA)

In this Wikipedia page, I contributed to this section by adding a new section regarding Health Disparities in East Oakland. I covered the following subtopics:

• Life Expectancy
• Health Conditions
• Healthcare Access
• Healthcare Coverage

Through these contributions, I added about 12 citations towards the article overall. I also edited a portion of the introduction to flow into the succeeding information on the Wikipedia page.

Sector

In this Wikipedia page, I contributed to this section by expanding on secondary healthcare/prevention through providing information on one example of how it has been implemented within various communities: chronic disease self-management programs. I wanted to expand more on this topic and provide an in-depth understanding of secondary prevention, its prevalence within communities, and how successful these programs have become since its implementation. While contributing this new example underneath the subsection of secondary health/prevention, I also added 8 new citations towards the page. Finally, I also minorly edited the wording of the introduction, adding a sentence here and there, but mainly just fixing the sentence structure and wording of the page.

— Preceding unsigned comment added by Iyernikita (talk • contribs) 03:51, 14 February 2018 (UTC)