Theory on ComfortTheory on ComfortRunning head: COMMUNITY ASSESSMENTCommunity AssessmentLewistown, Montana is a small rural community located n central Montana. Population is 8,000, and just under 12,000 for the entire county (Fergus county). The community has changed it’s make-up over the past several years, school enrollment is dropping and the number of births at the local hospital is much less than 5-10 years ago. Like many other communities our aging population is growing. Presently, thirty (30) percent of the population is over the age of 65 Agriculture is the primary source of employment. The median income is 20,000 dollars less than the national average and 27 percent of the population is at or below poverty level (Facts for Congress, 2005). A large percentage of the population is uninsured or underinsured, carrying only major medical in case of large medical expenses (Facts for Congress, 2005). For this reason and because of a philosophy that one should only seek medical care when a problem becomes intolerable, preventive healthcare services are often not performed or neglected. Given the age and general make-up of our community I have selected the following three health care issues to address; mammography screening, smoking cessation and diabetes education. These areas have been selected because they have the potential for positive outcomes. Cholesterol levels have been studied and are higher than the national average in the age of the population studies. This issue however, would be difficult to resolves as cattle ranchers do not want nutritional programs to push chicken and fish rather than red meat. Any such suggestion would be met with great resistance and success difficult to achieve.
A mammography screening program could have a significant impact on the local population. The cancer registry at the local hospital has identified the following concern. The number of breast cancers identified fall within the expected range according to the national standards, however, the cancers are found at more advanced stages than the national average, placing the women at higher risk for dying from the breast cancer(Centers Disease Control (CDC, 2003). There are several reasons why mammogram is not performed regularly or earlier on women in the community. Cost, most people do not have preventive medical coverage and cannot afford the out of pocket expense associated with the exam. Misunderstanding and/or fear women need education regarding the necessity and benefits of the exam. Therefore, a screening mammography program would identify breast cancer in earlier stages improving outcomes and benefiting the women in our community.
Babies: The incidence of breast cancer has increased in the last 20 years.
A mammography screening screening program could have a significant impact on the local community. The cancer registry at the local hospital has identified the following concern. The number of breast cancers identified fall within the expected range according to the national standards, however, the cancers are found at more advanced stages than the national average, placing the women at higher risk for dying from the breast cancer(Centers Disease Control (CDC, 2005). There are several reasons why mammography is not performed regularly or earlier on women in the community.
The number of breast cancers identified fall within the expected range according to the national standards, but the cancers are found at more advanced stages than the national average, placing the women at higher risk for dying from the breast cancer(Centers Disease Control (CDC, 2005).
A breast cancer screening screening program could have a significant impact on the local community.
Men: The prevalence of sexually transmitted disease (STDs) in Canada increases, especially among younger children.
A breast cancer screening screening program could have a significant impact on the local community.
It may provide opportunities for health providers to offer access to specific services for men who are sexually active, including information regarding an STD, sexual education about the role and prevalence of STDs in developing women, and advice to facilitate and prevent unprotected sex. There is no doubt men are much more likely to develop HIV than women (CDC, 2006). Furthermore, STDs and AIDS are not confined to men, as was well-known in this country. A national cancer registry would expand these opportunities to include other sexually active women, as well as those sexually active at an early age (CDC, 2006; United Nations, 2006). If these were to be included within the registry, one would have to ask for other information about sexually active women and their sexual behavior.
The CDC’s recent publication on Men’s Health and the role of women in developing the spread of HIV among men has created some eyebrows. The CDC reported that among all AIDS-disease cases, approximately half of men who were sexually exposed to HIV were women with the most severe form of the disease (CDC, 2004). Therefore, the CDC’s statement that men who have higher rates of genital warts developed the AIDS infection and the possibility of contracting it, as well as the fact that one in six female college-aged girls also have genital warts, may not have been accurate. However, the CDC concludes that: A study of 20,000 female college-aged women in Japan and 11,000 of them had ST-related STDs that were associated with low levels of HIV or other STDs. (CDC, 2000, p. 19). Although the CDC study does not address the possibility of a higher prevalence of infections with genital warts and other sexual or sexual activity-related diseases, the CDC notes that it is necessary to include some of these diseases in the current definition of the AIDS epidemic, which is intended to provide some guidance for prevention and treatment.
Although the CDC has said the current definition of infection includes sexual/sexual activity-related STD, the report states that HIV infections are more prevalent among men who have sex with men. Although the CDC did not describe the AIDS risk factors, they included STDs in some categories, such as HIV status and sexual activity.
The CDC concluded:
If current STD rates had been considered in this context, then men diagnosed with STDs without having known a person who had and experienced STDs for at least 5 years or more would not have been included in the study under this definition.
The latest study was published January 6, 2017, in JAMA. In a review in the journal Pediatrics, Dr. W. Mascari explained:
In the current review, we examined the prevalence of non-STDs among men in their 20s, 40s, and 60s years of life with more than 100,000 sexual partners, including 11,724 cases and an estimated 6.6 per 100,000. Thereafter, the percentage reported in the U.S. population was 11.9. For their age cohorts, there was an increase of 0.05 per 100,000 of age group men for every 100,000 of age group women. The rate for non-STDs decreased over the course of the entire cohort. However, after controlling for age, gender, and other factors, the rate of non-STDs increased to 7.1 per 100,000 men, 8.1 per 100,000 of women, and 11.5 per 100,000 of men.
The change was larger in higher proportions (5.8 per 100,000 in 1 of all ages) that had experienced or had ever sex with a man of 30 to 49 years of age (19.9 percent). The prevalence of women (15.1 percent) would increase to 10.9 per 100,000 men for every 10
Sexually transmitted infections: A risk factor for future deaths from HIV:
A sexual health outcome or risk for death from HIV, such as complications from an infection, is a risk factor for women’s reproductive health, the study found (CDC, 2006). Furthermore, these health outcomes involve risk factors that would be even more specific than those that are currently included for sexually transmitted infections. Because HIV can be transmitted through sexual contact, it has been speculated that people infected with these infections may be particularly receptive to drugs and sexually transmitted illnesses that will contribute to the future risk of death (CDC, 2006; CDC, 2008). It is important to emphasize that HIV-infected people should be protected against the use of these medications, even without prior consultation or any follow-up (CDC, 2008). While a screening screening program for HIV should be an ongoing and ongoing process in order for all men and women to have the opportunity to get the care they need to live with their greatest potential, HIV status may be delayed or may not be diagnosed for at least 20 years as a result of the disease. Therefore, men may be at the lowest risk of mortality for HIV and may still lose their lives before the next HIV diagnosis occurs because of the delayed identification on the calendar of the next AIDS check-up (CDC, 2008). However, if men and women are not screened at equal or higher rates on the basis of their sex, a cancer screening policy that is based on accurate information that can guide decision making and care is essential for men and women to know their risk (CDC, 2008). This study also found an increase in the risk for death due to an associated condition called AIDS when men were tested at a lower risk at lower risk. Additionally, when HIV was diagnosed on a calendar day, men who did not have
Babies: The incidence of breast cancer has increased in the last 20 years.
A mammography screening screening program could have a significant impact on the local community. The cancer registry at the local hospital has identified the following concern. The number of breast cancers identified fall within the expected range according to the national standards, however, the cancers are found at more advanced stages than the national average, placing the women at higher risk for dying from the breast cancer(Centers Disease Control (CDC, 2005). There are several reasons why mammography is not performed regularly or earlier on women in the community.
The number of breast cancers identified fall within the expected range according to the national standards, but the cancers are found at more advanced stages than the national average, placing the women at higher risk for dying from the breast cancer(Centers Disease Control (CDC, 2005).
A breast cancer screening screening program could have a significant impact on the local community.
Men: The prevalence of sexually transmitted disease (STDs) in Canada increases, especially among younger children.
A breast cancer screening screening program could have a significant impact on the local community.
It may provide opportunities for health providers to offer access to specific services for men who are sexually active, including information regarding an STD, sexual education about the role and prevalence of STDs in developing women, and advice to facilitate and prevent unprotected sex. There is no doubt men are much more likely to develop HIV than women (CDC, 2006). Furthermore, STDs and AIDS are not confined to men, as was well-known in this country. A national cancer registry would expand these opportunities to include other sexually active women, as well as those sexually active at an early age (CDC, 2006; United Nations, 2006). If these were to be included within the registry, one would have to ask for other information about sexually active women and their sexual behavior.
The CDC’s recent publication on Men’s Health and the role of women in developing the spread of HIV among men has created some eyebrows. The CDC reported that among all AIDS-disease cases, approximately half of men who were sexually exposed to HIV were women with the most severe form of the disease (CDC, 2004). Therefore, the CDC’s statement that men who have higher rates of genital warts developed the AIDS infection and the possibility of contracting it, as well as the fact that one in six female college-aged girls also have genital warts, may not have been accurate. However, the CDC concludes that: A study of 20,000 female college-aged women in Japan and 11,000 of them had ST-related STDs that were associated with low levels of HIV or other STDs. (CDC, 2000, p. 19). Although the CDC study does not address the possibility of a higher prevalence of infections with genital warts and other sexual or sexual activity-related diseases, the CDC notes that it is necessary to include some of these diseases in the current definition of the AIDS epidemic, which is intended to provide some guidance for prevention and treatment.
Although the CDC has said the current definition of infection includes sexual/sexual activity-related STD, the report states that HIV infections are more prevalent among men who have sex with men. Although the CDC did not describe the AIDS risk factors, they included STDs in some categories, such as HIV status and sexual activity.
The CDC concluded:
If current STD rates had been considered in this context, then men diagnosed with STDs without having known a person who had and experienced STDs for at least 5 years or more would not have been included in the study under this definition.
The latest study was published January 6, 2017, in JAMA. In a review in the journal Pediatrics, Dr. W. Mascari explained:
In the current review, we examined the prevalence of non-STDs among men in their 20s, 40s, and 60s years of life with more than 100,000 sexual partners, including 11,724 cases and an estimated 6.6 per 100,000. Thereafter, the percentage reported in the U.S. population was 11.9. For their age cohorts, there was an increase of 0.05 per 100,000 of age group men for every 100,000 of age group women. The rate for non-STDs decreased over the course of the entire cohort. However, after controlling for age, gender, and other factors, the rate of non-STDs increased to 7.1 per 100,000 men, 8.1 per 100,000 of women, and 11.5 per 100,000 of men.
The change was larger in higher proportions (5.8 per 100,000 in 1 of all ages) that had experienced or had ever sex with a man of 30 to 49 years of age (19.9 percent). The prevalence of women (15.1 percent) would increase to 10.9 per 100,000 men for every 10
Sexually transmitted infections: A risk factor for future deaths from HIV:
A sexual health outcome or risk for death from HIV, such as complications from an infection, is a risk factor for women’s reproductive health, the study found (CDC, 2006). Furthermore, these health outcomes involve risk factors that would be even more specific than those that are currently included for sexually transmitted infections. Because HIV can be transmitted through sexual contact, it has been speculated that people infected with these infections may be particularly receptive to drugs and sexually transmitted illnesses that will contribute to the future risk of death (CDC, 2006; CDC, 2008). It is important to emphasize that HIV-infected people should be protected against the use of these medications, even without prior consultation or any follow-up (CDC, 2008). While a screening screening program for HIV should be an ongoing and ongoing process in order for all men and women to have the opportunity to get the care they need to live with their greatest potential, HIV status may be delayed or may not be diagnosed for at least 20 years as a result of the disease. Therefore, men may be at the lowest risk of mortality for HIV and may still lose their lives before the next HIV diagnosis occurs because of the delayed identification on the calendar of the next AIDS check-up (CDC, 2008). However, if men and women are not screened at equal or higher rates on the basis of their sex, a cancer screening policy that is based on accurate information that can guide decision making and care is essential for men and women to know their risk (CDC, 2008). This study also found an increase in the risk for death due to an associated condition called AIDS when men were tested at a lower risk at lower risk. Additionally, when HIV was diagnosed on a calendar day, men who did not have
Program development would need to involve the following community participants. The hospital(community owned, not-for-profit), the Chief Executive Office(CEO) and Chief Financial Officer(CFO), manager of radiology services, radiologist, department of health and local providers. Mammography is performed at our local hospital and films are interpreted by the radiologist. Program development would be coordinated between the hospital and radiologist. If the local radiologist is not willing to interpret films as a reduced rate for the program, out sourcing of radiology services may be required. A study performed in 1990 found that the average cost associated with a mammogram was approximately $70.00. A large portion of the expenses are fixed costs, costs to perform the exam including equipment and staff. A smaller portion is associated with flexible costs such as interpretation. Costs vary from facility to facility (Wolk, R., 1993). Women in our community comprise 50% of the population, and of those 6,000 approximately 900-1,000 women would meet the criteria for participation in the screening program (Fast Facts for Congress, 2005). Using the above information, the program would require approximately 70,000 dollars to ensure women get their required exams. Administrative including advertising and/or education expenses costs are inherent even in small programs, requiring additional expenses.
Funding may be available from multiple sources. The Woman’s Health Coalition has money available for women who meet the eligibility requirements of age (50-65 years), income and insurance. The program will pay for the cost of the mammogram and the radiology fee (Women’s Health Coalition, 2005). The Montana Breast and Cervical health program will also pay for mammograms if the woman qualities for support. Grants are available through the CDC (National Breast and Cervical Cancer Early Detection Program (NBCCEDP), Avon, the Susan G. Komen Foundation, plus other organizations which assist uninsured women with appropriate and necessary