Depression can be a warning sign that there are more serious potential consequences unless the depression is treated.
Background factors that contribute to the issue: The HP2010 offers ten leading health indicators, and within those are sub-categories that add up to "467 science-based objectives" (HP2010). All the objectives are designed to eliminate or reduce some of the pivotal problems relating to the following background issues.
Too many disabled people are "limited by environmental factors" (they don't have access to buildings, recreational activities or transportation); there are too many people with "negative attitudes" about disabilities (this affects the social climate for those who are disabled); many disabled people are either limited in their access to educational opportunities or have no access at all; persons who are disabled too often have limited access to "career development, career opportunities, job placement and job satisfaction"; many disabled people have "limited or no participation in governmental decision-making on issues that directly affect their lives, voting activity, and opportunities to run for public office" (www.cdc.gov).
Local data available: Thanks to good coordination with CDC, Healthy People 2010, the Surgeon General's Office and other federal agencies, every state has the ability to "identify and access" the health status of disabled people because all states have a "Behavior Risk Factor Surveillance System" (BRFSS). In Missouri, for example, local officials are providing preventative measures for children attending camps this summer; any child that has a cough or otherwise appears to have flu symptoms, should be sent home since the "swine flu" -- Novel Influenza A (H1N1) Virus -- is highly contagious. In "Healthy Kentucky" one of the local goals is keeping one's weight under control by exercising and making good meal decisions. Solid information is made available in Missouri. And in Delaware ("Be Healthy Delaware") there are four "broad-based" goals set in terms of avoiding disabilities: a) promoting healthy behaviors; b) promoting healthy communities; c) "preventing and reducing diseases and disorders"; and d) "improving health systems."
Community health nursing interventions & strategies (Watson's Theory of Human Caring): Certainly the national government has provided leadership through the HP2010 and the CDC, but on a local, human-to-human level, there is much to be done to alleviate the suffering that many disabled people endure. One aspect of Watson's approach is the use of "carative factors" as "clinical caritas" (as a compliment to medication or physical therapy). For example, a community health volunteer (or professional) could offer hands-on carative support for an obese person who is so obese he is disabled. That person needs a radical change of diet, but also, he desperately needs exercise, so the carative support person goes on the exercise with the obese person. Alongside the obese person, a walk in a park for 20 minutes three times a week is carative.
Watson's "Transpersonal Caring Relationship" (TCR) relates to a nurse's "caring consciousness" in the protection of human dignity. For example, a mentally disabled person in an institution needs to get out of the building and breathe fresh air. A nurse could embrace a TCR and take that patient for a walk every afternoon. Healthcare in the bigger context is not necessarily about taking a person's temperature or writing reports for the physician. A nurse can help heal a disabled person by protecting the human dignity for that afternoon walk. The ripple effect from that altruistic act by the nurse can help change and heal the whole community.
Be Healthy Delaware. (2009). What is the Healthy Delaware 2010 Plan? Retrieved July 25,
2009, from http://www.behealthydelaware.org/2010plan.html.
Centers for Disease Control and Prevention. (2009). Disability and Health. Retrieved July 25,
2009, from http://www.cdc.gov/ncbddd/dh/hp2010.htm.
Centers for Disease Control and Prevention. (2009). People with Disabilities Can Lead Long,
Healthy Lives. Retrieved July 26, 2009, from http://www.cdc.gov/features/disabilities/.
Healthy People. (2009) What are the Leading Health Indicators? Retrieved July 25, 2009, from http://www.healthypeople.gov/LHI/lhiwhat.htm.
Missouri Healthy People. (2009). Interim CDC Guidance on Day and Residential Camps in Response to Human Infections with the Novel Influenza A (H1N1) Virus. Retrieved July 24,
2009, from http://www.cdc.gov/h1n1fllu/camp.htm.
Kentucky Healthy People. (2008). Physical Activity and Fitness. Retrieved July 26, 2009, from http://publichealth.state.ky.us/healthy_ky_2010.htm.
Watson, Jean. (2008). Jean Watson's Theory of Human Caring. Retrieved July 25, 2009, from http://www.nursing.ucdenver.edu/faculty/caring.htm.