NR 717 Week 7 Discussion

Student Name

Chamberlain University

NR-717: Concepts in Population Health Outcomes & Health Policy

Prof. Name

Date

NR 717 Week 7 Discussion

Identify

Hello esteemed officials at the Mississippi State Department of Health,

My name is Angelica Waller, MSN, BSN, RN, and I am currently advancing my education by pursuing a Doctor of Nursing Practice (DNP) in Healthcare Leadership at Chamberlain University. Over the past seven years, I have served as a registered nurse in multiple healthcare settings, including hospitals and outpatient clinics. Presently, I hold the position of nurse manager for the step-down intermediate care telemetry unit at Moore’s Park Memorial Hospital.

My nursing journey began at the bedside as a floor nurse, where I actively volunteered in community clinics serving uninsured and underserved populations. Even after assuming a leadership role, I have remained committed to service by organizing mobile health clinics, community outreach events, and health education workshops. My academic and professional interests center on improving health equity, expanding access to care, and advocating for sustainable public health funding, particularly for populations disproportionately affected by hypertension and cardiovascular disease.

Situation

Citizens residing in Jackson, Mississippi, particularly within the African American community, experience alarmingly high rates of hypertension, which frequently progress to chronic cardiovascular conditions.

Why is this issue important?

This issue is critical because social determinants of health (SDOH)—including low socioeconomic status, limited education, and restricted access to healthcare coverage—are directly linked to hypertension-related disparities. If these factors remain unaddressed, African Americans will continue to face an increased risk of premature death, poor health outcomes, and diminished quality of life.

This concern aligns with the mission outlined in H. Res. 238 (IH), 114th Congress (2015), which sought to recognize health disparities during National Minority Health Month. The resolution highlighted disparities among African Americans, Hispanic Americans, Native Hawaiians, Alaska Natives, American Indians, Asian Americans, and Pacific Islanders.

In Jackson, Mississippi, addressing hypertension represents a public health priority. The ongoing lack of affordable insurance, coupled with structural inequities and low health literacy, underscores the urgent need for system-based policies and sustainable interventions to improve community outcomes.

Background

The Mississippi State Department of Health (MSDH) plays a vital role in promoting equity and addressing preventable health challenges. Mississippi consistently ranks among the highest states in heart disease mortality, with recent data placing it second nationally (McCoy, 2024).

Although the Affordable Care Act (ACA) and Medicaid expansion have improved coverage, notable gaps persist. Adults living below the poverty line without dependent children are frequently excluded from affordable care options (Raphael & Rudowitz, 2024). Consequently, many delay or avoid seeking care altogether, leading to worsened conditions.

As a practicing nurse in underserved areas, I have witnessed how financial barriers, fear of medical debt, and distrust in healthcare systems deter patients from obtaining timely treatment. Additionally, low health literacy often prevents effective management of chronic diseases such as hypertension.

Case Example: Jackie’s Story

A compelling example of these disparities is the story of Jackie, a 52-year-old African American woman from Jackson. Jackie postponed medical care for symptoms such as leg swelling, cramps, nausea, and vomiting—largely out of fear of hospitalization and lost wages. When she eventually lost her job and insurance, she was diagnosed with kidney and heart disease.

Financial constraints forced Jackie to skip dialysis sessions and prevented her from maintaining consistent transportation to appointments. Tragically, she passed away at home due to complications from uncontrolled hypertension.

Jackie’s experience exemplifies how systemic barriers, unaffordable healthcare coverage, and inadequate community resources contribute directly to preventable deaths among marginalized populations.

Assessment

Effectively addressing health inequities in Jackson requires multifaceted interventions targeting healthcare access and the broader social determinants of health.

Table 1

Issues, Impacts, and Proposed Interventions

Evidence indicates that integrating community health workers (CHWs) into healthcare teams significantly improves hypertension control and reduces overall cardiovascular risk (Williams & Cooper, 2019). By addressing health literacy, economic stability, and insurance coverage simultaneously, Mississippi can lay the groundwork for sustainable health equity.

Recommendations

The Mississippi State Department of Health is encouraged to prioritize the following policies and initiatives:

• Expand access to affordable health insurance, particularly for childless adults.

• Invest in community-based health services that engage residents in planning and decision-making.

• Enhance collaboration between social service agencies and healthcare systems for holistic care delivery.

• Increase preventive services, including free or subsidized cardiovascular and hypertension screenings.

• Integrate CHWs into healthcare teams to boost patient engagement and adherence.

• Address structural racism through mandatory cultural competency and implicit bias training.

• Support Medicaid reform to close gaps in healthcare access.

Request

I respectfully seek the opportunity to collaborate with the Mississippi State Department of Health in the following ways:

• Designing and implementing health education programs tailored for underserved populations.

• Establishing mobile clinics and community screenings for early disease detection.

• Launching a 12-month pilot intervention project, followed by evaluation and community feedback surveys to assess impact.

By uniting stakeholders, healthcare providers, and policymakers, Mississippi can make measurable progress toward reducing health inequities and ensuring quality care and dignity in treatment for African Americans in Jackson.

Salutation

Thank you sincerely for your dedication to improving health outcomes for disadvantaged populations. Please do not hesitate to reach out for further collaboration.

Sincerely,
Angelica Waller, MSN, BSN, RN

References

Chelak, K., & Chakole, S. (2023). The role of social determinants of health in promoting health equality: A narrative review. Cureus. https://doi.org/10.7759/cureus.33425

Ercia, A. (2021). The impact of the Affordable Care Act on patient coverage and access to care: Perspectives from FQHC administrators in Arizona, California and Texas. BMC Health Services Research, 21(1). https://doi.org/10.1186/s12913-021-06961-9

Erlangga, D., Suhreke, M., Ali, S., & Bloor, K. (2019). The impact of public health insurance on health care utilization, financial protection, and health status in low- and middle-income countries: A systematic review. PLOS One, 14(8), e0219731. https://doi.org/10.1371/journal.pone.0219731

Jurns, C. (2019). Using SBAR to communicate with policymakers. Online Journal of Issues in Nursing, 24(1), 13. https://doi.org/10.3912/OJIN.Vol24No01PPT47

McCoy, M. (2024, February 22). Mississippi has the 2nd-highest heart disease mortality rate in the US. WJTV 12 News. https://www.wjtv.com/living-local/focused-on-health/mississippi-has-2nd-highest-heartdisease-mortality-rate-in-us/

Raphael, J., & Rudowitz, R. (2024, March 12). A closer look at Medicaid expansion efforts in Mississippi. KFF. https://www.kff.org/policy-watch/a-closer-look-at-medicaidexpansion-efforts-in-mississippi/

Williams, D. R., & Cooper, L. A. (2019). Reducing racial inequities in health: Using what we already know to take action. International Journal of Environmental Research and Public Health, 16(4), 606. https://doi.org/10.3390/ijerph16040606