Poverty and the Access to Health Services in Morristown New Jersey
Robert Loperfido
Felician College
Professor Sara Thompson, DNP, RN, APN-C
Poverty and the Access to Health Services in Morristown New Jersey
Having access to quality health care services is important for the success of health equality and for escalating the quality of a healthy life for everyone. For health services to be successful there needs to be timely access to health services to achieve the best health outcomes. It requires three separate steps; gaining entry into the health care system, accessing a health care location where needed services are provided, and finding a health care provider with whom the patient can communicate and trust (Healthy People 2020, 2014).
Access to health care impacts overall mental, social, and physical health status and when people have access to quality health care there is prevention of disease, increased quality of life, preventable death and higher life expectancy. There are many disparities that affect individuals in access to health services. Inadequate access to health care impacts people’s ability to reach their full potential. Barriers to accessing quality healthcare include: lack of availability, high cost and lack of insurance coverage. These barriers lead to unmet health needs, delays in care, inability to get preventive services, and preventable hospitalizations.
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... needs to help. People with mental health problems: Assessments for people in need of mental health services are carried out under the Care Programme Approach, which ... of any assessment is to improve the quality of life of the client unfortunately care workers often focus merely on the needs ... a copy of his or her care plan, or knowing where it is kept and having access to it – The language ...
When understanding access to health services, there are four components: coverage, services, timeliness, and work force. Health insurance coverage helps patients get into the health care system. Uninsured people do not receive medical care, have poor health status and die younger. When there are available services and an ongoing source of care, people end up with better outcomes and fewer disparities. Having a primary care provider is especially important when developing meaningful relationships. Patients have greater trust, better communication and the likelihood to receive appropriate care. The ability for health care systems to provide health care quickly after a need is recognized is an iatrical part to improving outcomes for patients living in poverty. Finally, health care providers play an important role in the health of the community they serve.
Morristown, New Jersey, in Morris County, is 5 miles SW of Parsippany, New Jersey and 16 miles W of Newark, New Jersey. The town is considered part of the Newark metropolitan area. Morristown has a population of 18,544. The first European settlers arrived in this area in the early years of the 17th century. At that time a substantial trade involving furs existed between the natives of the region and the Europeans. The English captured this area in 1664 and Sir George Carteret took control of it. According to historical records, the first permanent settlement of Europeans began in 1715 with the founding of a village called New Hanover. The area was incorporated as Morristown in April 1865. Morristown has been called the military capital of the American Revolution. The residents of the town have preserved their glorious history very well and the area is home to many places of historical significance (City Town Info, 2014).
According to the 2014 United Way ALICE Report-New Jersey, 26 percent of the households in Morris County are either on the financial brink, or in poverty. ALICE is a United Way acronym that stands for “Asset Limited, Income Constrained, Employed.” ALICE households earn more than the official U.S. poverty level but less than the basic cost of living. There are 40,753 households (23%) struggling, with 8,837 (14.6%) living below the U.S. poverty line and 31,916 (18%) in Morris County falling into the ALICE population. Based on the Household Survival Budget, it takes $62,290 for a family of two adults, an infant and toddler to afford the basics in Morristown, which is more than double the U.S. poverty rate of $22,113 (The United Way, 2014).
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People living in Morristown who do not have access to quality health care is very important to the community. 14.6% of the residents have income below the poverty line. Males between the ages of 16 – 24 are the highest that live below the poverty line in Morristown. Hispanic and Latin Americans are the leading races of poor residents that live below the poverty level. Married couple families make up 39.3 % of the poor as well as Females with children make up 48.2% of the poor population living in Morristown.
When poor people have access to quality health care they are able to see the doctor more often so they feel better which intern people feel less depressed and are better able to maintain financial stability. A study done by the National Institute on Aging in 2011 found that those with Medicaid were 35 percent more likely to go to a clinic or see a doctor, 15 percent more likely to use prescription drugs and 30 percent more likely to be admitted to a hospital. Women with insurance were 60 percent more likely to have mammograms, and those with insurance were 20 percent more likely to have their cholesterol checked. They were 70 percent more likely to have a particular clinic or office for medical care and 55 percent more likely to have a doctor whom they usually saw. The insured also felt better: the likelihood that they said their health was good or excellent increased by 25 percent, and they were 40 percent less likely to say that their health had worsened in the past year than those without insurance (City Data, 2014).
The community is concerned about the people that live in Morristown. The healthier the population of the city the healthier and more stable the community. As people become more involved within the community the stronger and healthier the community becomes. There are a number of community programs in Morristown that have been established to assist its residents who live below the poverty line. Homeless Solutions, Inc. is a non-profit agency that can help people who are facing an eviction, and who are currently homeless. They provide legal advice, information on assistance programs, counseling, and other services. Morris County is planning on receiving almost $1 million for a “homeless prevention, rent aid, and rapid re-housing assistance program” for families that are in need of short-term rent or mortgage help. The aid is intended to help people make it thru a short term hardship and is not intended to be long term aid. These funds will be made available to individuals and families, to help with paying utility bills, rental assistance, moving costs, security deposits, motel or hotel vouchers, and a wide variety of other bills and expenses. Also, help can be provided for employment training, medical bills and debt, mental health, credit counseling, and even legal advice (Need Help Paying Bills, 2013).
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HMOs Take The 'Care' Out Of Health Care. In the early 1990 s insurance companies, in attempt to control spiraling medical costs, created what would be termed "health maintenance organizations", also known as HMOs. What HMOs do is create a team of physicians and medical personnel that the patients agrees to use. Within the contracts both the patient and the doctor sign, limits and restrictions are ...
Morristown and the community value its residents and the politicians understand that when the community is physically and mentally healthy so is the city. With these programs in place, Morristown and its residents expect greater outcomes, more business that supports a better tax base, and increased opportunities.
Currently 4.7% of the community has not seen a medical provider when they needed to. Two questions were asked. Question number one; in the last 12 months, was anyone in the family unable to get medical care, tests, or treatments they or a doctor believed necessary? And the second; in the last 12 months, was anyone in the family delayed in getting medical care, tests, or treatments they or a doctor believed necessary? The results of the survey found that 10% of all persons were unable to obtain or delayed in obtaining necessary medical care in 2010. The goal would be to reduce the number of people not receiving medical care by 10% If the community were to reduce the proportion of persons who are unable to obtain or delay in obtaining necessary medical care, dental care, or prescription medicines by 10%, it would impact overall physical, social, and mental health status, prevention of disease and disability, detection and treatment of health conditions, quality of life, preventable death, and life expectancy (Healthy People 2020, 2014).
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... to improve patient outcomes and reduce unwarranted practice variation. Regardless of how health care organizations implement ... the case when it comes to prescribed medication, its known side-effects and the ... Outputs Contingencies Cause, effect and impact on Medical and Dental Filling shortage roles and ... applying an eligibility system called “fair access to care”. People are eligible for help if ...
The data was collected by The Medical Expenditure Panel Survey (MEPS).
MEPS produces nationally representative estimates of health care use, expenditures, sources of payment, insurance coverage, and quality of care for the United States civilian non-institutionalized population. The survey features several rounds of interviewing covering 2 full calendar years. MEPS consists of three components: (1) the Household Component, a nationally representative survey of the civilian non-institutionalized population; (2) the Medical Provider Component, which collects data from medical care providers and facilities reported as providing care to persons interviewed in the Household Component; and (3) the Insurance Component, which collects data on the types and costs of workplace health insurance (Healthy People 2020, 2014).
Three behavioral goals for the objective of reducing the number of residents in Morristown who have not obtained or delayed in obtaining necessary medical care are to provide easier access to medical care for those residents who are unable to afford or physically travel to see a medical professional, provide easier access to and more affordable prescription medications, and increase the number of persons who receive appropriate evidence based preventive services.
Morristown has very good public transportation services for it residents, many of the people are unable to take advantage of the system because they cannot afford to use the system, unable to physically take public transportation and do not have insurance to help pay for the transportation. One strategy that would improve the access to medical services would be to allow Morristown residents who have appointments to see medical professionals, free rides on busses and trains. The resident would show a special card with the date of the appointment and this would give them access to public transportation for free. Another strategy to increase the number of people in Morristown access to medical care would be to establish mobile healthcare vehicles. There are close to 1000 people who are homeless in Morris County, about 350 people live in or around Morristown according to Project Homeless. This program focuses on the use of vehicles, ranging from passenger vans to custom-designed clinics on wheels, to provide a variety of health services to people without stable housing. The use of mobile clinics complements and often enables better outreach that is usually conducted on foot by many health care professionals. A third strategy to improve access to medical care would be to provide medical screenings to grade school children while in school. This program would provide health screening on grade school children to help detect early signs of childhood disease as well as provide education on healthy foods and diet. Childhood obesity is a growing epidemic that causes many of the diseases like CAD and Diabetes in adults. Many of these high morbidity conditions can be controlled or even prevented if caught earlier in childhood.
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America has a highly developed health care system, which is available to all people. Although it can be very complex and frustrating at times it has come a long way from the health care organizations of yesterday. Previously most health care facilities were a place where the sick were housed and cared for until death. Physicians rarely practiced in hospitals and only those who were fortunate could ...
The second behavioral objective is to provide education, easier access and more affordable prescription medications. Patients with chronic conditions and the lack of consistent care are at risk for very poor health outcomes. Patients who do not have primary care providers and access to pharmacies negatively impacts the quality and safety of care delivered. Medications play an essential role in managing chronic conditions, however without coordinated care there are bigger risks of adverse drug events related to duplication of therapy, interactions, or incorrect dosages. Adverse drug events continue to be a leading cause of death and injury in the United States. Education and the ability to manage chronic disease are keys to obtaining good health status.
As more people access quality health care there will be a need to educate those patients to maintain a good health status. The patient first must have an understanding of the reason for the medication. If a patient has been diagnosed with Type II Diabetes, they must first have a basic understanding of their disease. The following information needs to be reviewed with the patient: brand, generic name, function, how, when, length of time the medication is taken, possible side effects, foods, refills (if necessary) and medication storage. The medication needs to be easy for the patient to take. It is important patients are educated on dosages so that not to take too much of the medication. Literature in multiple languages needs to be provided to the patient in easy to read language. Knowing the patient understands the instructions given is just as important as teaching about the medication. If the patient does not understand the likelihood of the patient to continue to take the medication is unlikely. To follow up with patients and prevent non-compliance set up a program with the pharmacist to develop drug administration schedule that can be easily followed by the patient.
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There are a myriad of issues that concern current federal health policies. These new issues emerged from a number of health policy agendas. Several issues are emerging as of late due to the notion that health care is usually perceived as prelude to issues concerning physical health problems. Federal health policies range from mental illnesses and physical therapy issues. The four central issues ...
Prescription medication is useless if the patient does not have access to the medication. Programs need to be established to deliver the much needed medications to patients. Not everyone has the means or the ability to go to the pharmacy when they need regular medication refills. Patients with chronic or recurring conditions need a reliable, secure supply of their preferential medicine. In the same way, patients with movement disabilities might have difficulty making it to a pharmacy for their medications on a regular basis. With these limitations in mind, many patients turn to home delivery options for their prescriptions. Numerous brand name and generic medications can be delivered via the post office or private courier services, eliminating the need to go out for one’s medicine.
Residents of Morristown who live under the poverty line or who are homeless cannot afford the high costs of prescription medication. What good is a program that provides increased access to health care for the poor and homeless if they cannot afford the medications needed to maintain good health status? A free discount program run by the United Networks of America (UNA) aims to lower the cost of prescription drugs and other health services for all people regardless of income or age. With discounts up to 75%, the program seeks to help people with no or inadequate insurance gain access to more affordable medications, dental care, hearing exams, eyeglasses and diabetic supplies (“Free Program Helps Provide Affordable Prescriptions,” 2013, p. 1).
To increase the number of persons who receive appropriate evidence based preventive services that live in poverty or are homeless, Morristown will need to develop screening services that check for diseases before there are any symptoms. Screenings can help doctors find diseases early, when the diseases may be easier to treat. Getting screening tests is one of the most important things you can do for your health. Depending on your age and sex, you may need to be screened for certain types of cancer, high blood pressure, high cholesterol, diabetes, osteoporosis, and sexually transmitted diseases.
After the community is educated on the importance of health screenings and to maintain good health status the community will have to be educated on how to maintain good health records and history. Through education through flyers, brochures, and advertisements the community will learn to improve the quality of health care their family will get. To take charge of the family units health they will have to learn to keep track of important health information, know the health history of the family and see the doctor for regular checkups Evidence based preventative service will also include how the residents of Morristown to take charge of their health.
Many factors influence health and well-being in a community, and many resources and individuals in the community have a part to play in responding to community health needs. When creating a health improvement program, every community will have to consider its own particular situation, including factors such as health concerns, resources, capacities, social, and political perspectives. There is no special potion to improve the health of the community. The implementation of interventions works to increase awareness, access, and demand for the service in the community. Effective collaborations involve a process through which citizens, advocates, government officials, and other stakeholders explore obstacles, differences, and alternative strategies for improving access to health care. Diverse, credible leaders from key arenas must be the visible champions of the process. These may include people from churches, schools, local government, businesses, hospitals, clinics, social service agencies, and consumer advocacy groups, as well as health care providers such as doctors, dentists, and nurses.
Program evaluation can include a wide range of methods to evaluate a particular program. There are different methods to gathering data to determine if a program is successful. Surveys and questionnaires provide quick and easy information from people in a non threatening way. The advantage of this form of information collecting is that it can be completed anonymously, inexpensive to administer, and easy to compare data. Interviews will be conducted to understand the experiences of the people utilizing the programs. The advantage of interviews is that the interviewer gets the full range and depth of the experience. Documentation review will help with the getting comprehensive and historical information. Observation is a way to gather accurate information about how a program actually operates, particularly about processes. The advantage of this type of evaluation is being able to view operations of a program as they are actually occurring.
Morristown is growing and as the population grows so do the needs of its community. Politicians, church leaders, stakeholders, physicians and nurses need to work collaboratively to provide better outcomes for its poor and homeless. With the inception of mobile heath care vehicles, better comprehensive multi-language teaching materials and affordable medications, Morristown can increase the amount of people’s access to healthcare. More access to quality health care will result in a stronger community.
References
City Data. (2014).
http://www.city-data.com/city/Morristown-New-Jersey.html
City Town Info. (2014).
http://www.citytowninfo.com/places/new-jersey/morristown
Free Program Helps Provide Affordable Prescriptions. (2013).
Retrieved from
Healthy People 2020. (2014).
https://www.healthypeople.gov/2020/topics-objectives/topic/Access-to-Health-Services
Medical Expenditure Panel Survey (MEPS) – Healthy People 2020 [Fact Sheet]. (2014).
Retrieved from www.healthypeople.gov/2020/data/datasource.aspx?id=66
Need Help Paying Bills. (2013).
The United Way. (2014).
http://www.unitedwaynnj.org/ourwork/income.php